Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
, . �► <br /> FIREPLACES �,� <br /> � <br /> Gas factory fireplace Cj � <br /> Wood burning factory fireplace with flue I �, l(��� <br /> Wood Stove � <br /> Wood stove with flue "�� <br /> Brand Name Model No. <br /> VENTILATION <br /> No. Kitchen E�aust ducted recirculating cfin <br /> No. �_ Bath E�iaust (must be du ted outside) cfm <br /> No. �_ Other Fans: Locations ^ �;� �e,b �� <br /> FUEL STORAGE (MUST BE APPROVE BY FIRE MARSHAL) <br /> Installation Remo <br /> Fuel oil: gallons undergrou inside outside <br /> LP Gas• gallons <br /> O r Gas opening <br /> � <br /> PERI�IIT �EE CALCULATION <br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.00) <br /> � -`�� �,- �`� � x .0125 $ � � <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 /> -. . � . . . � .,,.... .es.r fwr s�acwes.ri�s.! . <br /> 3. Postage and Handlin� (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ <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 uistallation 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 /> 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,OOO,p00 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 witli the ordinances of the City and the regulations of the Mirinesota <br /> � ` State�Building Code, and certifies that all statements made_on this application.are complete, true � <br /> . �w,-,,. _ ,. , <br /> . rt :;� <br /> and correct. <br /> �_-:. <br /> Applicant's Signature: � . �� � , Date: .,;J J_..:^l � �- ^. <br /> Approved By: Date: <br />