Laserfiche WebLink
4 <br /> 4V�J�OD BUR.�IIlVG EOUIPMENT <br /> Wood stove with flue <br /> Wood combination or add-on <br /> Factory fireplace with flue <br /> _� Factory Fireplace (s) Freestanding Masonry <br /> Wood Stove �) Franklin, other <br /> , <br /> Brand Name /'���v�.�_�-r;,r.c.�,; Model No. `�f y;� <br /> Mfgr's Min., Cleararices, side , rear , min. flue dia. <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 out�ide <br /> LP Gas: gallons <br /> Other Gas opening <br /> PERMIT FEE CALCULATION <br /> 1. 1.25%o of Contract Price* or Minimum Fee ($35.00) � <br /> x .0125 $ .3 -��U� <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 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 estunated 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 <br /> customer for the work done. If any material, equipment, labor; or installation are furnisheci by the owner, <br /> tenant or any other party the reasonahle �a:ket value of such item� must be added to the estimated cost <br /> or contract price for pernut fee purposes. In the event that there is a dispute on the amount of the job cost, <br /> the City may 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 <br /> greater. 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 <br /> all 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 /> � ��' �r� r''C,l� ;^`�_ i��� �' _ `' %, ,' '� <br /> Applicant s Signature: �- � �, � � ' Date: 1� +';; , �'�'� <br /> Approved By: Date: <br />