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� ��,-� S 4 �Y��� �;. �� � ��� � � <br /> ; i <br /> ._ . .,�.. � . _. . . .. ' _ � r�r� .. �. . �'£� k-'._ _ ..��s �?-u _,.�3 �y . <br /> :� <br /> ` ` _ S <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 /> �.,. <br /> No. Kitchen Exhaust ducted recirculating cfm � <br /> No. Bath Exhaust (must be ducted outside) cfm � <br /> �,�; <br /> No. Other Fans: Locations cfm � <br /> �� <br /> '�� <br /> � <br /> FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) �A <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 /> (� C <br /> "�'x .0125 $ <br /> ���, (contract pr'ce) �ri <br /> 2. State Surchar�e. �`* Add the State Buildin ode Division � <br /> ' Surcharge to each permit. % x .0005 $ � <br /> �i� or $.50, whichever is greater (contract price) `� <br /> ��.� �� <br /> � 3. Posta�e and Handlin� (Only mail-in applications) $ 1.50 <br /> ��: <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ <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 /> price for permit.fee purposes. In the event that there is a dispute on the amount of the job cost, the City may <br /> request the submission of a signed copy of the actual contract. � <br /> ,�; <br /> �l ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or $.50 -whichever is greater. k; <br /> � For valuations over $1,000,000 call the Department of Inspectional Services for the price. �i <br /> �� 5t: <br /> � The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all �; <br /> �� 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 /> G ; // � � "k <br /> .�?�� ._S�/l� -� � <br /> ' r' � .f '^ Date: � ✓ � <br /> ¢ Applicant's Signature:/ --�it-�-t-c / rt% <br /> � Date: � <br /> Approved By: ` �� <br /> ���r ,�� <br /> � � _ . � , ' .. �� <br /> , r � <br /> ���� . �_.__ � .�.,_ �� ._. . � � `t�.��, _ � ..,.�.., .� . __ � ».h: r >a ' .,� � ��� <br /> aa '' ,�`t^_.� s ,i;�.�..Sr,d ?:a- j�'�3 ¢., �_ .�'4.a1���._'�.`l.F s :��.,.�di <br />