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. " .. . 1.Q.�.. _ :��_ <br /> �" /`a � _ ' ' �l��,^+ 4� .. ' <br />, `,,, - . . � �:.�. <br /> � .�.�` � � :w <br /> S� <br /> ' 'r f <br />:..�� <br /> � WOOD BURNING EOUIPMENT <br /> Wood stove with flue <br /> Wood combination or add-on <br /> 1 ��. Factory fireplace with flue <br /> Factory Fireplace (s) Freestanding Masonry <br /> Wood Stove (s) Franklin, other <br /> Brand Name Model No. <br /> Mfgr's Min., Clearances, side , rear , min. flue dia. <br /> ��� <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 (MUS�,BE APPROVED BY FIRE MARSHAL) <br /> ' Installation Removal <br />� , <br /> � Fuel oil: gallons underground inside outside <br />�Y LP Gas: gallons <br /> Other Gas opening <br />� <br /> PERMIT FEE CALCULATION `~ <br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.00) <br />�' x .0125 $ � <br /> ' u�C�('i'� �� c� � � <br /> G � <br /> �(contract price) � <br /> n ;� 2. State Surchar� ** Add the State Building Code Division <br />�`'` Surcharge to each permit. x .0005 $ <br /> r,. <br /> r, or $.50, whichever is greater (contract price) �''� <br /> 3. Postage and Handling (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 estunated dollar amount charged for the pernutted <br /> 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 fumished by the owner, <br /> tenant or any other party the reasonable market value of such items must be added to the estimated cost <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 />�:: ** 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 /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do <br />�'�n£,= all work in strict accordance with the ordinances of the City and the regulations of the Minnesota <br /> State Building Code, and ce ' s that all statements made on this application are complete, true <br /> - and correct. <br /> �.: //1 /.�-�� <br /> Applicant's Signature: � � Date: ( C� <br /> Approved By: Date: ' <br /> z x: <br /> �� <br /> �, � , <br /> . .„ <br /> . ; <br /> � . <br /> , ;. <br /> n , . .�. <br /> . . . . . _ <br /> : <br /> _ , , - . <br /> , _ <br /> . :, , < . � ; . :- x: , <br /> � <br /> A - - � .. � _ , � � .. 4 . . . . � . . <br /> \ <br /> . " � � . - . . . " , . . . . . .. � .. � .- '� . �.. <br />