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� <br /> � .. <br /> � <br /> « O O D �LR��'G E Q UIP?�iF�1T <br /> ��Vood stove with flue <br /> `�'ood combination or add-on <br /> F�actory fireplace with flue <br /> Factory Fireplace (s) Freestanding Masonry <br /> «'ood Stove (s) Frailklin, o[her _ <br /> E3rar.d \ame I�lodel No. <br /> �1fgr�s '�1in., Clearances, side , rear , min. flue dia. <br /> ��E�TIL_�TION <br /> ti��. Kitchen Exhaus[ ducted ___ recirculating cfm <br /> ;�'�. 1 �3ath Exhaust (must be ducted outsi�le) cfm <br /> �o. 1 Other Fans: Locations Laundry room_ cfrn <br /> I�L�1=L ST(�RAGE �:�fUST BE APPROVED BY FIRE MARSHAL) <br /> 1�s�alla�ion Removal <br /> Fuel oi1: �allons underground inside outside <br /> LP Gas: Qallons <br /> Other _ Gas openinQ <br /> I'ER�1IT FEE C:�LCLZ�ATION <br /> : . 1 .��� of Contract Price* or �Iini►num Fee (�3�.00� <br /> 72f��.D0. x .012� $ _ ����� ---- <br /> (cvuuact price) <br /> �. S[ate Surchar�.�e. ** Add the State Buildin� Code Division <br /> Surc}l�r�e to each permit. �2��r� x .0005 S 3.60 <br /> or S.�0. w}lichever is greater (con�rac� pr�ce> <br /> _ . P��sta�e and ��andlin� (Only mail-in applications) � 1 .�0 <br /> TOT.�L PER:�'fIT FEE (Add lines 1-3 above) � �3.-6�0 _ <br /> ` CO�TR.-�CT PRICE or JOB COST means the accual er estima[ed dollar amount charged tor �he pe;r:;�tec <br /> �xor:� inc!�.idir.� materials, labor, profit, and o�her fixed cos�s. It is the amount to be chareed [o [he <br /> cus��me; 1or che ��ork done. If any material, equipmen[, labo-, or installation are furnished Uy che o�4ner. <br /> ;enar,< <�r :ul�� o�her party the reasonable markct vaiue of such i�ems must be added �o �he es�ima�ed :.os� <br /> o� cen��ac: price for permit fee purposes. In the event that there is a dispute on �he a.moun� of[he job cost, <br /> _he C�,«� ma�� reques� the submission oC a signed copy of [he actual con[rac�. <br /> -= i�.e 5;�:\TE SL�RCI�ARGE is .0005 of the contract price under S1,000,000 or S.�O - whic;�•��er i� <br /> =r��a;e: F�r valua[ions o��er 51,000,000 call the Departmen: of Inspection�il Secvices for !he pr;c::. <br /> �lhe undersianed hereby applies to the City for issuance of a Mechanical Permit, a«rees to do <br /> all �,t�;,rk ;n strict accordanee with the ordinances of[he Ciry and the regulations of the �linnesota <br /> S;a:� f3uifd:n« Code, and certifies tliat ali statements made on this application are complete. tn�e <br /> �nd correct. <br /> :�ppl;cant'�Si�nature: Date: 4-23-98 <br /> �r��r,���e� I3��: _ _ Date: �CJ � ��- <br />