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�:=:u,�. . . . . <br /> ..— . � <br /> w.' <br /> 5,f <br /> ��•, � WOOD BURNING EOUIPMENT �� <br /> Wood stove with flue <br /> f r - Wood combination or add-on <br /> ` e' 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. 9� <br /> VENTILATION <br /> No. / Kitchen Exhaust ducted recirculating cfm � " <br /> � [ <br /> No. ,3 Bath Exhaust (must be ducte d outside) c fm - <br /> No,_ .' Other Fans: Locations cfrn �� <br /> .� <br /> - � <br /> FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) <br /> Installation Removal r��= <br /> • Fuel oil: gallons underground inside outside �'� <br /> LP Gas: ' gallons ;y; <br /> Other Gas opening ;� <br /> r PERMTT FEE CALCULATION .z' „;� <br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.00) a; <br />_. /� ��`: 5'�� x .0125 $ �: <br />, H� <br /> (contract price) �, <br /> 2. State Surchar� ** Add the State Building Code Division :� <br /> Surcharge to each permit. x .0005 $ � � <br /> or $.50, whichever is greater (contract price) �� <br /> 'A< <br /> �;i <br /> � <br />`�,: 3. Postage and Handlin� (Only mail-in applications) $ 1.50 � <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ '' z� 3.c��> �i <br /> * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the pemutted s� <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 fumished by the owner, �. �; <br /> tenant or any other party the reasonable market value of such items must be added to the estimated cost ` `�' <br /> �` �x 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 /> �: <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. � '3 <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 t�e 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 /> .:-, <br /> � �� <br /> $;. <br /> Applicant's Signature: /l�� ��� Date: ���,v�� <br /> Approved By: Date: �k� <br /> ,.R i <br /> i <br /> �� <br /> ; . � r '7 <br /> ,: <br /> ' � � . � ' �sa <br /> ; , , - „ <br /> ,, _. , � :L.: � . ' , �`' �� <br /> " . , , . ,i.(�.•� . .. , .. . . �.� { � .. . ' . 1 � 4�.A/ � <br /> ir ... .�l�v_.:^r .. . . .. . �... _.. . !� � . .. ...,-. . . ... ...�[_ .. . �z '�. . <br />