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I►' <br /> � <br /> WOOD ING E UIPMENT <br /> ood stove with flue <br /> Woo combination or add-on <br /> Factory eplace with flue <br /> Factory Fire ace (s) Freesta g Masonry <br /> Wood Stove (s) Franklin, other <br /> Brand Name Model No. <br /> Mfgr's Min., Clearances, side , rear , min. flue dia. <br /> Total <br /> VENTILATION <br /> No. Kitchen Exhaust ducted recirculating cfm <br /> No. Bath Exhaust (must be ducted outs ) cfm <br /> o. Other Fans: Locations cfm <br /> otal <br /> FUEL STORAGE (MUST �APPROVED BY FIRE MARSHAL) <br /> Installat' �/ Removal <br /> Fuel oil: gallons i�erground inside outside <br /> LP Gas: gallons <br /> Other Gas opening <br /> PERMIT FEE CALCULATION <br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.00) <br /> /�lC� x .0125 $ <br /> (contract price) <br /> 2. State Surchar�e. ** Add the State Building Code Division <br /> Surcharge to each permit. x .0045 $ <br /> (contract price) <br /> or $.50, whichever is greater <br /> 3. Post�Le 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 dollaz amount charged for the pemutted <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 furnished by the owner, <br /> tenant or any other party the reasonable market value of such items must be added to the estimated cost <br /> or contract price for permit 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,OOO,Q00 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 ements made9p this application are complete, true <br /> and correct. �`� . <br /> , <br /> . � <br /> , . � �� Date: �����i - �� <br /> Applicant s Signature: <br /> Approved By: ��� Date: >/ ' l f� i� <br />