Laserfiche WebLink
� <br /> . , <br /> r IUEYL�c�s <br /> �--Gas factory fireplace <br /> Wood burnina factory fireplace with tlue <br /> Wood Stove � <br /> Wood stove �vith flue <br /> Brand Name � Model No. <br /> VE�TILATIO\ <br /> No. Kitchen Exhaust ducted recirculatin� cfm <br /> No. � Bath Exhaust (must be ducted outside) � cfm <br /> � �u. u�her Fans: Locati�ns cfm <br /> FUEL STOR�GE (MUST BE APPROVED BY FIRE MARSHAL) <br /> Installation Removal <br /> Fuel oil: gallons underground inside outside <br /> " LP Gas: �allons � <br /> Other � G�s openina <br /> � <br /> PER�IIT FEE CALCULATIO\T �O <br /> l. 1.25% of Contract Price" or ��Iinimum Fee ($3�.00) � <br /> !'c�� Oz�� . c� X .0125 � ��� � � � <br /> �contract price) � <br /> 2. State Surchar�e. "�" Add the Statc Buildina Code Division � � <br /> Surchar�e to each pei�mit. � x .000� $ � � � <br /> or �.�0. ���hichever is �reater (con�rac� price) � <br /> � , <br /> 3. PostaQe and Handlin� (Only mail-in applications�) S 1.50 ���0 <br /> 4. TOTAL PERMII' FEE (Add lines 1-3 above) $ �%��� � ��� <br /> " COtiTR�CT PRICE or JOB COST means the actual or es[imated dollar amount charged for �he permi[[ed <br /> �,vork includina materials, labor, profi�, and other fixed costs. It is the amount to be charoed to the custo«ler <br /> for the ���ork done. [f an}' nlaterial, equipment, labor, or installation are furnished by the o�vner, tenant or <br /> am� other parry the re�sonable market value of sueh items must be added to the estimated cost or contrac[ <br /> price ior permit tec purposes. In the event that�here is a dispute on the ainoiint of the job cos�, the Cit�,� ma�� <br /> request the submission of a signed copy of the actual contracl. <br /> *" The STATE SURCHARGE is .000� oi the contract price under SI,OOO,G00 or 5.�0 - whiche��er is �reater. <br /> For valua[ions over S 1,000,000 call the Departmen[ of Inspectional Services for the price. <br /> The undersi`�ned hereby applies ro the City for issuance of a Mechanical Permit, agrees to do all <br /> work in strict accorciance with the ordinances of the Ciry and [he 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 Si�nature� ����L� �i���� Date: ���� ��Z. <br /> Approved By: Date: <br />