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. _ , . . <br /> �. ,. - ,� <br /> . , . . <br /> : , <br /> . <br /> .�, <br /> w <br /> FIREPLACES <br /> as factory fireplace <br /> Wood burning factory fireplace with flue <br /> Wood Stove <br /> Wood stove with flue <br /> Brand Name \�"Z`-� �-�E�J� Model No. �'i� �-- <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 ($3�.00) <br /> '3 ���.C7 -C� C� x .0125 $ -4 O .��- <br /> (contract price) <br /> 2. State Surchar�e. ** Add the State Building Code Division <br /> Surcharge to each permit. a.aO:C�� x .0005 $ '� � � <br /> or $.50, whichever is greater (con ract price) <br /> 3. Postage and Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ �13 _��c <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 /> 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 /> and correct. <br /> Applicant's Signature: -- Date: �a--�� '�� <br />� Approved By: Date: r <br />�wnu <br />�;; <br />���. � � � � . � � � �� � , � � <br /> .:�.... ,µ...;�_.�_ 4_ �,�, �,� ,.f.Y. .. < _ . :._ ., _ . .. . .. . . <br />