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; - . . .,.. - � . . . , .. _�,.;�� 1 . � . � . <br /> . . ,. . .. _ . � .. . .. . . �. , a. . � � - . . � . � � . . �. � . . S ... . " . <br /> '.�:s: <br /> . <br /> �'�-, <br /> FIREPLACES - <br /> Gas factory fireplace <br /> Wood burning factory fireplace with flue <br /> Wood Stove <br /> Wood stove with flue <br /> Brand Name Model No. <br /> �;. <br /> � VENTILATION ;'` . ':f <br /> No. Kitchen Exhaust ducted recirculating cfm <br /> No. Bath Exhaust (must be ducted outside) cfm <br /> No. Other Fans: Lacati�ns 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) J � ��-{ <br /> �-.r�c�; i ;, �v=x .0125 $ i � <br /> (contract price) � <br /> 2. State Surchar�e. ** Add the State Bui�ing Code;Division `��- <br /> Surchargc to �ach permit. i�,�J � x .0005 $ <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 materiais, iabor, 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 j � <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 cer.tifies,that all statements made on this application are complete, true <br /> and correct. � � <br /> i / ' <br /> Applicant's Signature: , '�� �l� Date: � ��� 00 <br /> / ��--�i <br /> Approved By: ��, Date: <br /> r <br />