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. . <br /> ,�� �?. �-. �, - q� ,., . .:,, N <br /> �' . �., . • .� ,o <br /> . ' • � <br /> �j/�'� f-��^� p��r.L �' <br /> G EQUIPnZENT <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 �IC,�,��G`�G,'� Model No. � � �� <br /> Mfgr's Min., Clearances, side , rear , min. flue dia. s/� <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 STO£cAGE (MUST �E 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) ' <br /> �'�CX'� x .0125 $ �.>:G>� <br /> (contract price) <br /> 2. State Surcharge. ** Add the State Building Code Division <br /> Surcharge to each permit. x .0005 $ � �� <br /> or $.50, which�ver is greater (contract price) <br /> 3. Post�e and Handlin� (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT PEE (Add lines 1-3 above) $ ��i.U cu <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 are furnished by the 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 />�::; <br />; greater. For valuations over $1,�00,0�0 call the Department of Inspectional Services for the price. <br />�.- <br />�� ; <br />�`` The undersigned hereby appl i�;� to the City for issuance of a Mechanical Permit, agrees to do � <br /> all work in strict accurc!ance witli 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 `�F <br /> and correct. <br />��' Applicant's Signature: ��'1 Date: � �� l� <br />�:u: <br /> - Approved By: Date: <br /> ,_4, <br /> /�. �• . .. , ' . � ..8 � . .- . . . . .. .. . <br /> '.:` . . .. � . , . . . . . . .. <br /> . . �. <br /> '*:5.h�I.,�t..�_._�:i�:. �... ,....�:�:.', . ' ' ..,.._.e.=.�: , 1 � '... .'. . .__._�...._�._. .. _ <br /> ..: ,...._. _.._ ._,..._ . ......a.. .. .�..dc=. _ . .. ...._.�.�.�.��.._:.x-i�.._.�_ . <br />