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. -- <br /> FIREPLACES <br /> Gas factory fireplace <br /> Wood burning factory fireplace with flue <br /> Wood Stove <br /> Wood stove with flue <br /> Brand Name Model No. <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 /> (Contract Price) IS 2 51 05.00 x.0125 $ 32-0.0(o <br /> 2. State Surcharge. **Add the State Building Code Division <br /> Surcharge to each permit. (Contract Price) if 2S l CO 2.00 x.0005 $ f 2.80 or$.50 <br /> 3.Postage and Handling(Only mail-in applications) $ 1.50 <br /> 4.TOTAL PERMIT FEE(Add lines 1-3 above) $ 34-.3( <br /> *CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work <br /> including materials,labor,profit,and other fixed costs. It is the amount to be charged to the customer for the work done. <br /> If any material,equipment,labor,or installation is furnished by the owner,tenant,or any other party,the reasonable <br /> market value of such items must be added to the estimated cost or contract price for permit fee purposes.In the event that <br /> there is a dispute on the amount of the job cost,the City may request the submission of a signed copy of the actual <br /> contract. <br /> **The STATE SURCHARGE is.0005 of the contract price under$1,000,000 or$.50-whichever is greater.For <br /> 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 work in strict accordance <br /> with the ordinances of the City and the regulations of the Minnesota State Building Code,and certifies that all statements <br /> made on this application are complete,true and correct. <br /> Applicant's Signature: Date: (0`1`0 <br /> Approved By: Date: 6i t/—`-3' <br />