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01/19/1998 13:38 612-633-8884 FIRESIDE CORFJER PAGE 84 <br /> ,� � . , - <br /> WOOD BURNING EQiJ�NT <br /> Wood stove with flue <br /> Wood cambination or add-on <br /> Factory fiurep�ace with flue <br /> �./'�actory Firc�lace (s) Freestandivag Maso�oory <br /> Waod Stove (s) Frankiin, other <br /> Brand Name �'�,r ,. ; Model No_ .ST 73''� �I.Cr' <br /> M�g�r's Min., Clearances, side , rea� , min. flue dia. <br /> VFNTII,ATION <br /> No. Kitchen Exhaust ducted recirculating cfm <br /> No. Bath Extxavst (m�usc be ducted oucsidc) cfm <br /> No. Other Fans: Locatioz�s c�m <br /> FUEL STURA.CE (MUST BE APPItOV�D BY FIRE M,A.RSHAL) <br /> Installat�on RemoYa� <br /> Fucl oil: ga��o�s underg�cound i�osxde outsxde <br /> LP Gas: gallons <br /> Other Gas opening <br /> PERMIT FEE CALCULATI�N. <br /> 1. 1.25°� o� Contract Frice* or IvXin'unum Fee ($35.00) <br /> x .0125 $ �~'-�Z% <br /> (con�cracc price) <br /> 2. State Surcj�ge. ** Add t,l�e State Building Code Division <br /> Suzc�targe to each permit_ x .0005 $ . �.�S _ <br /> or $.50, whichever is greater (co�atract price) <br /> 3. Pos ,e ac�d Hand���g (O�ly mail-in applicacioz�.$) $ 1.50 <br /> 4. ?OT,AL PERNIIT FEE (Add li�nes �-3 above) $ ,�"7��S' <br /> ' C��AC'T PRICE or JOB GOST means chc acn,al or estimaud doUar atssount charged for ttae permitted <br /> wo�k i.nduding macerials, Labor, profic, and othar fixed costs. Ic �s cb�e amounc to be chuged co che <br /> cusro�mer for tiu work 8ona lf any ma�e�a1, equipmcn�, labor. or installation are furnished by the owaer, <br /> tenant or azry otb,cx patry the reasonable ma�ket �a1ue of such itetns must be �ded to the estimated cost <br /> or coneracc psice far penaa.ic fee purpos�s. In[he event thac there is a dispute on rhe amounc of cbe job cosc, <br /> the Ciry usay request the submission of a signed copy of the actual contract. <br /> ** '['he STATE SURCHARGE is .0005 of the coac�act price unde[ 51,000,000 or S_SO - whichever is <br /> greau�t. �or valUations over $1,000,000 call �he pepattment of Inspterional Services for the price. <br /> �e u�iersigned hereby applies to che City foz issuance of a Mecha�n,iical Perrnit, agrees to do <br /> all work in strxct accvrdance with the ordinancos of�he Ciry and the regulatio�s of th�e Minnesosa <br /> Stace Building Code, and cert�fies that ail statements made on tt�is application are complete, auc <br /> and correct. <br /> � �', � <br /> A��licant s sigz�awXe: ,,,�,�:w y�/. ,r�, nate: /1�-�� <br /> Appz�oved sy: Dare: <br />