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� � .:;t �'". ''�r� �:�fi -�-.. �. <e� '` .�..' „� „� � � <br />'�r r f� � �� 7 � � �� =-G 1 <br /> � 1 <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 /> 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 ($35.00) <br /> f���.�-, x .0125 $ �;«� <br /> -c ntract price) <br /> 2. State Surchar�e. ** Add the State Building Code Division <br /> Surcharge to each permit. 1(��3 �, � x .0005 $ , s� <br /> »� or $.50, whichever is greater (contracc price) <br />�� � <br /> '' �,,,.: <br /> 3. Postage and Handlin� (Only mail-in applications) $ `�� <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ :�ss� <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 /> t`'` rice for ermit fee u oses. In the event that there is a dis ute on the amount of the ob cost, the Ci ma <br />�~ P P P rP P J n' Y <br /> 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 greater. <br />� For valuations over $1,000,000 call the Department of Inspectional Services for the price. <br />�%; <br />�'� The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br />��::: <br />�. work in strict accordance with the ordinances of the City and the regulations of the Minnesota <br />��' State Building Code, and certi�'i�s that all s atements made on this application are complete, true <br />�-` and correct. <br /> Applicant's Signature: �°� ,� Date: 7 <br />�,, Approved By: Date: <br />��- <br />� ,,; ,. ,, , , � <br /> F ro: � <br /> :�5i Y �� h <br /> l��..+ ,«��:..c�... ..�x'S_., �..x _ ._ .., 4...w�2�.., 4 a E t`.:�,.. . _ .. ..., .... _ . _...� .. . . �.,�_d:.., .�..w.., . .. �x, . ,.._� , .. �. .i ��.o..r�.a�E.�§ul'�:..._.,...&.niLYa� <br />