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3-13-1998 3 E 5 M FR�1 F I RES I DE CORt�R 612 633 8884 P. 2 <br /> , _ ' -. ' � i <br /> �~ • � � <br /> ! � <br /> I I I � <br /> � �_ ood stove with flue <br /> i ood combination or add-on <br /> � actory fjxeplace with f�uc <br /> � � actory Fireplace (s} Freesta�3ing Masonry <br /> � �_ ood S�tQve (s) Franklin, ot�er <br /> Bra.�ad ame t�,le.a�` /� G.(,� Model No. - i � �(L.7` <br /> ; Mf�r' in., Clearances, side , rear , min. flue d"za. <br /> I I Tot� <br /> , <br /> � �No�, T{itchen Exhaust du�cted recirculating Cfiaa <br /> iNoa Batb: Exhaust (must be duct� autside) � cfm <br /> No� Othez' Fans: Locations cfm <br /> � ; T� <br /> � <br /> � {NNST BE APPROVED BY FIRE MARSHAI.) <br /> �T Ins 'on Removal <br /> � uel oil: gallons uriderground inside outside <br /> � �� LP Gas: gallons <br /> I �— Other Gas openin8 <br /> I �� <br /> C A N <br /> 1. I 1.Zj5 f Contract Price* or�imum Fee (�35.80) <br /> I ; �?�GO.�-� x .0125 $ �a.cac� <br /> I (contract price) <br /> 2. i S ** Add the State Building Code Dxvision <br /> � S e to each permit. ,��_.�, z .00OS $ /, i c� <br /> , <br /> � ' (conax�c price) <br /> � <br /> � or �.5 , whichevet is greater <br /> 3. � (Only mail-in applications) $ � <br /> 4. j I' PERMT!' FEE (A� li�es 1-3 above) $ ��„,�' <br /> i '' CO CT PRICE or JOB COST means rhe acwal or esamazed dollar amouat chargod for the perrmircad <br /> �� wo�c " ludiug �m,a�ials, labor, prcfit, a�.other fuai costs. It is the amount to be chuged to the <br /> I cus�o for rhe work done. If aay muerial, equipmenc,labor,or iustallatioA are furnished by the owner, <br /> � c�nsjnc any od�r parry dtie reasonabie market value of suc�►items must be�add�ad to the cscimated cost <br /> I or pricx for permic fee purposes. In the�vmt that ther�is a disp�te a�n tbe amonnc of rtu job cost, <br /> the ' may requesc tb�e aubmission of a si�aod oopy of tbe actual conaact. , <br /> I <br /> �* Tha T'E SURCHARGE 1�s .0005 of the contr� price u�ter S1,000,000 or 5.50 - whichever is <br /> 8re�r For valuations over S1,OOO,Q00 call rhe beQartnn�nt of IaspxtMaal Services far t}:e price. <br /> � <br /> 'Y't� under�i hesc�eby applies to the City for issuance o�a Me,x�a�oacal Permit, agrees to do <br /> all�►ork� accordance with the ordinances of the City and the regulations of the Minnesota <br /> State Buzl�' ode, and certifies that all statea�nts made on this application are complete, mt� <br /> ���• . <br /> Ap�lica�u'I�s S ture: ����,c�., ���b.a Date: / 4 _ <br /> I � <br /> Ap�provod�By . • .Dau: <br /> � <br /> , ; <br /> I <br />