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P.. .,Tae+.e,�. �.�.'€' ,..t`..� .-.��. .�,-;r '� .�*�;,. , ,ya•c;; r'° . ► „ <br /> .,� E: <br /> . �.'f• � -3�y . �� :*a.. . - <br /> �.�� � �: ' ' ..�.�. :. , . <br /> ,\ . i l 6 � t � _ <br /> 1` �� . . M1 . . '. . � �.1''. _ <br /> -` . � : .� . ..�. <br /> . . t ��. . ..�... i f�,. <br /> y s -.. .... . ...'�... ��.. <br /> s . . . . . ., , . . .. . � . � .. . � � . ' . _ . �. ..':.�'� y. � ,«� <br /> t t;�, <br />?;' FIREPLACES � `` ��='; <br /> � Gas factory fireplace � '' <br /> �> <br /> Wood burning factory fireplace with flue - <br /> Wood Stove <br /> Wood stove with flue - <br /> ; 'k <br /> \ Brand Name Model No. <br /> -�; - <br /> VENTILATION < <br />'�' No. Kitchen Exhaust ducted recirculating cfm <br /> No. _� Bath Exhaust (must be ducted outside) cfm a;` <br /> No. Other Fans: Locations cfm <br /> ��;, <br /> FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) - <br /> Installation Removal _ ,y�<s <br /> Fuel oil: gallons underground inside outside � �^; <br /> :9 <br /> LP Gas: gallons �' <br /> , � <br />,., Other Gas opening <br /> _ , �� <br /> PERMIT FEE CALCULATION '' ��r <br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.001 '� <br /> � ��� x .0125 $ �-! Q � ,��Z3 f� <br /> � (con ract price) ��.`� <br /> 2. State Surchar�e. ** Add the State Building Code Division � �; <br /> Surcharge to each permit. 3S �oG x .0005 $ l �l � b� <; K '� <br /> or $.50, whichever is greater (concracc price) =r `` <br /> 3. Postage and Handlin� (Only mail-in applications) $ 1.50 " <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ S o � , �,a �'' <br /> ;` <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 customer �,:-� <br /> for the work done. If any material, equipment, labor, or installation are furnished by the owner, tenant or , �. <br /> any other party the reasonable market value of such items must be added to the estimated cost or contract <br /> ' price for permit fee purposes. In the event that there.is a dispute on the amount of the job cost, the City may � � ' <br /> 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 greater. <br /> For valuations over $1,000,000 call the Department of Inspectional Services for the price. <br /> fi � <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> ' � 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 /> , <br /> - and correct. <br /> Applicant's Signature: /�� - - Date: �--� - � � <br /> Approved By: Date: �, <br />