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� , ��'� �,` �,� �}�iF� ."�.x � ,?��. '*� R ,V P�' i � „����4�F r .r ��1�'� <br /> . . H _ � t, � ,�t F '`f ;�� s''��;:_ 'n,t"� � '� � '��+t� � ;.,� .. � <br /> . i . <br /> j 5 r'p� . <br /> . j � �� Jw ryi, � F a <br /> .. . . � �,.: _ ., ° . �°t �, ..1;'� � �..5 F . a �'1 . <br /> . . � AF .l �k�. A,i:..�� �'. . � ��� '� r .. .. <br /> FIREPLACES � :�:��� �i�� � ;�� ,;�;; . <br /> Gas factory fireplace �� � . : � , � Y � <br /> Wood burning factory fireplace with flue �n � � ,.;�� � �.���,�� „ <br /> - .� '�:' S . . . . . <br /> Wood Stove � �� '��: .;;;� { . <br /> Wood stove with flue `� � w'� ";'��`r' <br /> - �� � <br /> ' � f . <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: Locatioris ' cfm � <br /> V e,� 1 ' t�-� � �J d � � <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 M' imum Fee„ 35.00 � <br /> 1 <br /> � x .0125 $ r� �,- <br /> (contract price) <br /> 2. State Surcharge. ** Add the te uilding Code Division <br /> Surcharge to each permit. � � �'�' x .0005 $ C�j,�� <br /> or $.50, whichever is greater . (contract price) <br /> ! 3. Postage and Handlin� (Only mail-in applications) � $ 1.50 <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) . � $ c�(o � � ���_ <br /> * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount chazged for the permitted <br /> ` work including materials,labor,profit,and odier fixed costs. It is the amount to-be cnarged tv tl�e cus�c�aier <br /> for the work done. If any material, equipment, labor, or installation aze fiunished 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 pLrposes. 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 Ciry 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 /> ' . . ' � : Date: 0/�/ <br /> Applicant s Signature:� �, � <br /> Approved By: Date: <br />