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'�. , . � .�: . ...... : ...... .-.'..:;.� s:,' n'w-v.. •s,:. ...r-. _ . . ......- . _ - � . . _. . _ . ...... .... <br /> � .. . ��, �... .., , � .;. _...... - , ..� . . . <br /> ._ . ._ .. . .. �. . . . . . ' . .. . . . �' . . . . . - . . . ... <br /> WOOD BURNING EOUIPMENT <br /> Wood stove with flue <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 Model 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 /> FUEL 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% of Contract Price* or Minimum Fee ($35.00) p <br />�: :� ' �'��i1• � x .0125 $ � �D • 7� <br /> (contract price) <br /> 2. State Surchar�e. ** Add the State Building Code Division / / <br /> Surcharge to each permit. �j'�j)�.���� x .0005 $ `-1� 7� <br /> or $.50, whichever is greater (contract price) <br /> 3. Posta�e 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 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 ihe work done. ii any materiai, equipment, labor, or instaliacion are iumished by tne 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 $1,000,000 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: Date: <br /> Approved By: Date: <br /> , . . <br /> _ : ..: . .._, .,; . <br /> :, , , <br />