Laserfiche WebLink
M��,�n�� �a� �x v �a <br /> ���� h�e r�c�o f��=� /� �1 �x v �J <br /> � � r <br /> �-BURNING EOUIl'MENT S f��^��n G��' <br /> � ��r,��:�r (t� <br /> � stove with flue ��=�=� Cus�. St��� <br /> Wood combination or add-on <br /> �_ Factory fireplace with flue <br /> Factory Fireplace (s) Freestanding Masonry <br /> Wood Stove (s) Franklin, other <br /> Brand Name /Y'����c��� , �'�y y,��,;��/;�,;t.rg�lodel No. � <br /> Mfgr's Min., Clearances, 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 /> F`��L STORAGE (MUST BE APPROVED BY FIRE MARSHAL) <br /> Installation Removal <br /> Fuel oil: gallons underground inside outside <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 /> ' UC`�L? �'z��� x .0125 $ �/ J�UC� <br /> (contract price) <br /> 2. State Surchar�e. XX Add the State Building Code ivision <br /> Surcharge to each permit. � ���: x .0005 $ �� , L� �� <br /> or $.50, whichever is greater (contract price) <br /> 3. Posta�e and Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ `� �, :�U <br /> * CONTRACT PRICE or JOB COST means the actual or estimated 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 aze furnished by the owner, <br /> teri2I?�Ot 2I1� OC�:e; F3If� t�;e ::BS:,IlZ�:e ;,,:.ii:�i ti'aliic Gi SiiC�'i itEirit IT1iiSt �'ic added to tne estimated cos[ <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 $1,000,000 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 /> Applicant's Signature: .� �� 6✓ l�ate: <br /> Approved By: Date: <br />