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.,,.�_ <br /> ` , ; «;, � <br /> - r4. ;- � yl . j ' . s. � . . ��\ � <br /> � , S? �. '�ti' i � <br />� �� : ���� � � � �� ., � <br /> � , � <br /> s� <br /> 4 � �� �` ��; <br /> �#i;��..' r�, '. � Jy !j ��y � <br /> �,, WOOD BURNING EQUIPMENT . � �=� �� <br /> - � � . �i -4 ., , .., . . W�� <br /> {�i..��� � $ �. '*1 eV` �.�EJ' [�� . . ;'! ���� <br /> Wood stove with flue <br /> � � � <br /> . . �f ����. �.. �• . _ <br /> '� Wood combination or add-on �` <br /> �� � <br /> � , �. <br />��ty ? � Factory fireplace with flue ;� <br /> Factory Fireplace (s) Freestanding Masonry " <br /> Wood Stove (s) Franklin, other <br /> � Brand Name Model No. � <br /> @�i . <br /> � Mfgr's Min., Clearances, side , rear , min. flue dia. ,�;. <br /> ;, ' '#;a,.� <br /> �. <br /> ��� <br /> � VENTILATION '�' <br /> �� ' No. Kitchen Exhaust ducted recirculating cfm ,� <br /> � < <: ` <br /> �•� No. Bath Exhaust (must be ducted outside) cfm <br /> �' No. Other Fans: Locations cfm <br /> "x. � <br /> �`�� FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) <br /> ,� <br /> ' Installation Removal <br />� <br /> ' Fuel oil: gallons underground inside outside � ' <br />�., <br /> LP Gas: gallons <br /> z= Other Gas opening <br />��$� ��;; <br /> ; �� <br /> PERMIT FEE CALCULATION ��'_ <br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.00) <br /> x .0125 $ <br /> (contract price) ' <br /> 2. State Surchar�e. ** Add the State Building Code Division ,�� <br /> Surcharge to each permit. �^,�'� °-- x .0005 $ <br /> { or $.50, whichever is greater (contract price) <br /> 1.50 � <br /> 3. Postage and Handlin� (Only mail-in applications) $ .�A <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ ', �� <br /> �; <br /> * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted s s <br />}�r' n work including materials, labor, profit, and other fixed costs. It is the amount to be chazged to the � �^ <br /> customer for the work done. If any material, equipment, labor, or installation are furnished by the owner, ;y <br /> tenant or any other party the reasonable market value of such items must be added to the estimated cost <br /> ,�! <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 /> a; <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 /> s: ° <br /> ;; ' <br />�!x, 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 />�;�, <br />'�`�` State Building Code, and certifies that all statements made on this application are complete, true <br /> ;. :� <br /> ra : <br /> and correct. ,;}� <br />�; � � � � - �`� <br /> t Date: '�'' <br /> Applicant's Signature: �1x� ,� -� `��' �A' <br /> '� <br /> Approved By: Date: _ �� <br /> 3 <br /> .:�.: <br /> �J� <br /> s' n x .�;< .� °� <br /> ,��` <br /> �., � � : <br /> �;p �3 ` ` � <br /> ' ..�: v. . �i i r.. <br /> I x F . . �,x? ���t+F � ., se � .., w....._��.e,�L.f6rc....,w�v�.r...ti:a..a.w:s� . �.� <br />