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FIREPLA �S ��f� .� �'�,C' <br /> Gas factory�ee �� �- <br /> Wood burning factory fireplace with flue <br /> Wood Stove <br /> Wood stove with flue =� r --' <br /> ,(�� - �-!'Z���� /1�I/% � <br /> �-� ` � <br /> Brand Na �-lC� odel No. <br /> / <br /> r <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 /> �L�j"�� `z`' x .0125 $ � 7, .��_. <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 e and HandlinQ Onl mail-in a lications $ 1.50 , � <br /> � � � Y PP ) , <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ _�����j, � 2`�.�p <br /> � <br /> * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted c <br /> work including materials, labor, nrofit, and other fixed costs. It is the amount to be charged to the customer =J <br /> for the work done. If any material, equipment, labor, or installation are furnished by the owner, tenant or s�-'�� <br /> any other party the reasonable market value of such items must be added to the estimated cost or contract �� 0 <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 /> ** � �.� <br /> The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or $.�0 - 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: ' , Date: � � �C� '� <br /> Approved By: Date: <br />