Laserfiche WebLink
� � � <br /> WOOD BURN G E UIPMENT <br /> Wo stove with flue <br /> Wood c bination or add-on <br /> Factory fire ce with flue <br /> Factory Firepla (s) Freestanding 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 �����,i)� �?N',�l _ <br /> No. _� Kitchen Ex�aust ducted recirculating cfm <br /> No. �_ Bath Exhaust (must be ducted outside) cfm <br /> iVll. � VU1Gi t iiliS: J.�(.7::ilLililiJ � � %��+ <br /> Total <br /> FUEL ST(�RAGE (MUST B APPROVED BY FIRE MARSHAL) <br /> Ins�llation Re oval <br /> Fuel oil: g lons underground inside outside <br /> LP Gas: gal <br /> Other Gas opening <br /> PERMIT FEE CALCULATION <br /> 1. 1.25 0 of Contract Price* or Minimum Fee 35.00 <br /> �y .Z= Y X i.Zs $ ,��� _.� <br /> (contract price) <br /> 2. State Surcharge. ** Add the State Building Code Division ,� <br /> Surcharge to each permit. �-�,j,�D�?r `'� x .0005 $ �� ,` <br /> (contract price) <br /> 3. Postage and Handlin� (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ 6� ,(,� J� <br /> * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted <br /> �N�rk includi_ne 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 aze furnished by the owner, <br /> ten�uit 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 [he actual contract. <br /> ** The STATE SURCHARGE is .000� of the contract pr;ce under $1,000,000 or $.50 - whichever is <br /> greater. For valuations over $1,000,000 call the Uepactment 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 conect. - -- <br /> ,- <br /> �' -�`� // Da ���'G�.� <br /> A licant's Si nature:' � f� ,% te: <br /> PP � <br /> Approved By: Date: <br />