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' � ...i �: • <br /> 'i `�` , f F � " , � <br /> . ��i_ <br /> � ;�� �� <br /> �,�,�:`F �_ r �. �� <br /> WOOD BURNING EQUIPMENT � ,�;� J F. . <br /> Wood stove with flue � i ' � <br /> Wood combination or add-on '� ` <br /> � �. � <br /> 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., Cleazances, side , reaz , min. flue dia. �� <br /> k <br /> VENTILATION <br /> No. Kitchen E�chaust ducted recirculating cfm <br /> No. Bath Exhaust (must be ducted outside) cfm <br /> No. Other Fans: Locations cfin <br /> FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) <br /> Installation X Removal .� <br /> T Fuel oil: ,�O gallons X underground inside � outside �y <br /> LP Gas: gallons -?+ <br /> Other Gas opening ;'. <br /> r <br /> PERMIT FEE CALCULATION <br />, s 1. 1.25% of Contract Price* or Minimum Fee ($35.00) � <br /> yc�C� X .O12S $ "l !�• G� � <br /> � <br /> (contract price) <br /> 2. State SurcharL�e. ** Add the State Building Code Division <br /> Surcharge to each permit. x .0005 $ ,�. �rz% `� <br /> 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) $ J � . ��- '�` <br /> 'j <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 permit fee purposes. In the event that there is a dispute on the amount of the job cost, � <br /> :t <br /> the City may request the submission of a signed copy of the acival contract. ' j �f <br /> :,� <br /> '� <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 /> all work in strict accordance with the ordinances of the City and the regulations of the Minnesota 'x <br /> State Building Code, and certifies that all statements made on this application are complete, true <br /> � and conect. <br /> : <br /> ` ll-q� <br /> Applicant's Signature: ��--- Date: %� - 1 <br /> Y,: � <br /> ,. <br /> ; , <br /> ��` Approved By: Date: a. <br /> ,; },� <br /> � � �� , y,� '` ;;� � � � . � � . -� �� <br /> , . .. .. . � <br /> ; ,. _ ,- <br /> ,. .. , - , , ::: � , � .�: �: � .,;. <br /> - ; * . , '� ^ , . ';, <br /> � <br /> ; � � �� _ _ C, ;y� <br /> � � - , �.�:_ . � . . . . _. <br />