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FIREPLACES <br /> Gas factory fireplace <br /> '7( Wood burning factory fireplace with flue <br /> Wood Stove <br /> Wood stove with flue <br /> Brand Name >i f r p j QC g ±to rartY1 cu--1.- Model No. {— rA 36 <br /> VENTILATION <br /> No. Kitchen Exhaust ducted recirculating cfm <br /> No. Bath Exhaust (must be ducted outside) cfm <br /> No. Other Fans: Locations cfm <br /> FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) <br /> Installation Removal <br /> Fuel oil: gallons underground inside outside <br /> LP Gas: gallons <br /> Other Gas opening <br /> PERMIT FEE CALCULATION <br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.00) <br /> 35OQ, 0 0x .0125 $ 3, 7S <br /> (contract price) <br /> 2. State Surcharge. ** Add the State Building Code Division <br /> Surcharge to each permit. 3500 o v x .0005 $ j , 7 3-- <br /> or <br /> or $.50, whichever is greater (contract price) <br /> Wawa kVA <br /> 3. Postage and Handling (Only mail-ii ;iii sisii , $ 1.50 <br /> 4. TOTAL PERMIT FEE (Add 1jee.A �JIOOHS $ y 7 0 U <br /> ElItt sgtegoIl <br /> * CONTRACT PRICE or JOB COST means the ac '.0.ttataed 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 <br /> for the work done. If any material, equipment, labor, or installation are furnished by the owner, tenant or <br /> any other party the reasonable market value of such items must be added to the estimated cost or contract <br /> • pricefor permit fee purposes. In the event that there is a dispute on the amount of the job cost, the City may <br /> request-the submission of a signed copy of the actual contract. <br /> ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or $.50 - whichever is greater. <br /> For valuations over $1,000,000 call the Department of Inspectional Services for the price. <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 certifies that all statements made on this application are complete, true <br /> and correct. // <br /> Applicant's Signature: ..11/' �G"( 7 Date: 1// 3/6 <br /> Approved By: Date: <br />