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� <br /> - . � <br /> ? � <br /> WOOD BURNING EQUIPMENT <br /> Wood stove with flue V; <br /> Wood combination or add-on � <br /> Factory fireplace with flue � <br /> � <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 /> 1 <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 (MUST BE APPROVED BY FIRE MARSHAL) <br /> Installation Removal �'� <br /> �, <br /> Fuel oil: gallons underground inside outside '�. <br /> LP Gas: gallons ';5 <br /> Other Gas opening h <br /> .� <br /> PERMIT FEE CALCULATION <br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.00) , <br /> x .0125 $ / Sn c�, `" <br /> (contract price) � <br /> 2. State Surchar� ** Add the State Building Code Division � <br /> Surcharge to each permit. x .0005 $ �� <br /> or $.50, whichever is greater (contract price) <br /> � <br /> 3. Postage and Handling (Only mail-in applications) $ 1.50 � <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ y <br /> � <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 � <br /> customer for the work done. If any material, equipment, labor, or installation are furnished 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 pernut 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 /> � <br /> all work in strict accordance with the ordinances of the City and the regulations of the Minnesota ;� <br /> State Building Code, and certifies that all statements made on this application are complete, true � <br /> and correct. , <br /> � � <br /> ; = � ----_ � � <br /> . - <br /> Applicant's Signature: ��� '� � � Date: ���3 �� � <br /> Approved By: Date: p2 � <br /> �. <br />.� . 5 :;yJ —:�T„� -�� ��i: — � . •�k*' S ,�.s � <br />�'«,'F� �l'�x� ,Y' {� .�" �-.-.tfi'� �.�, ' . S F i ' ✓..,:;�'� h�j�,�' �.<. <br /> ', � <br /> � �,° � . i "' � �y.�:' ' �`�t�:. F n . � ' ,A��, `.r '� , <br /> �� � � � .7 . z �„�y. y��w ,�. €� . � j� . . f���w[ r <br /> . <br /> ��..�.u_f' ... . , ....x...Cde�.��w.a .3.h�h�..`PP�t....�4. I .. ixd.lx..... , .. .. . . � . ... � ......,6 Y ,..._. ,. . , _. ��1.°.,.�. .. +�L,� <br />