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<br /> FIREPLACES
<br /> Gas factory fireplace -
<br /> Wood burning factory fireplace with flue
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<br /> Wood Stove ,{`
<br />'`� Wood stove with flue
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<br />' Brand Name Model No. ;� ,
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<br /> � .` ; VENTILATION „�
<br /> No. Kitchen E�chaust ducted recirculating cfm �' '
<br /> f :` No. 1_ Bath Exhaust (must be ducted outside) cfm �k
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<br /> � I�1o. ^vther Far�s: Locations cfm
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<br /> #� FLTEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) �
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<br /> Installation Removal ;�
<br /> Fuel oil: gallons underground inside outside '�
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<br /> LP Gas: gallons
<br /> Other Gas opening
<br /> � PERMIT FEE CALCULATION :
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<br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.00) ��. `a
<br /> Z(;�� x .0125 $ � �- �
<br /> (contract price) �
<br /> S�: 2. State Surcharge. ** Add the State Building Code Division �F�., � �
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<br /> Surcharge to each permit. x .0005 $ � �,,
<br /> - or $.50, whichever is greater (contracc price) ���
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<br /> 3. Posta�e and Handlin� (Only mail-in applications) $ 1.50 , t�',
<br /> ,�, 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ d�7 •j 7 `�
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<br /> - * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted
<br /> work including materials, labor,profit, and other fixed costs. It is the amount to be charged to the customer �'
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<br /> for the work done. If any material, equipment, labor, or installation are furnished by the owner, tenant or �f
<br /> T,4 any other parry the reasonable market value of such items must be added to the estimated cost or contract ��.;
<br /> price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, the City may t 4 y�;
<br /> request the submission of a signed copy of the actual contract. ,�;
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<br /> ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or 5.50 - whichever is greater.
<br /> For valuations over $1,000,000 call the Department of Inspectional Services for the price.
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<br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all
<br /> - work in strict accordance with the ordinances of the City and the regulations of the Minnesota �_:�..�
<br /> State Building Code, and certif'ies t at all statements made on this application are complete, true ��`
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<br /> and correct.
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<br /> Applicant's Signature: � Date: t:.
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<br /> A' Approved By: (; Date:
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