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. -� � �� _. .-4_.. _.�____. - .�_ �. -T,,,.�__..__ .� _ ._.� -„T._.�-.._ .� <br /> F <br /> i � <br /> k � <br /> L � <br />� <br />� FIREPLACES <br /> Gas factory fireplace�,�s�� � <br /> Wood burning factory fireplace with flue <br />� Wood Stove <br />; Wood stove with flue � <br /> Brand Name �e..��-lr� 1VIode1 No. /4�—��►�e,.�_ <br /> VENTILATION � <br /> No. Kitchen Elchaust 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 /> 4 Other Gas opening <br />� <br />� <br />' PERMIT FEE CALCULATION <br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.00) �� <br />' �.3�.,� x .0125 $ �s^' <br /> (contract price) <br /> 2. State Surchar�e. ** Add the State Building Code Division <br /> Surcharge to each permit. x .0005 -$ � . ) ,� <br /> or $.50, whichever is greater (contract price) <br /> 3. Posta.ge and Handlin� (Only mail-in applications) $ .50 <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ '?Z�. �s <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 <br />� for the work done. If any material, equipment,labor,or installarion are furnished by the owner,tenant or <br /> any other party the reasonable mazket 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 <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 /> 4 <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 />� <br />; � <br />� Applicant's Signature: � ,2 Date: ��–,�3 �� � <br />' Approved By: Date: � <br />