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��� _,'`..-�-•'�.� . � . �'� y^.,. �,.-�F'�,. ., . rr s-..`-'�'�'C"""i5'�fiR"'}�"'�. T" . �i . . ,. . <br />�';�:.�.;.. <br /> i <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 /> 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 APPRCVED BY FIRE MARSHAL) <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 /> �7 3 o x .oi2s $ 35 _ �c� <br /> (contract price) <br /> 2. State Surcharge. �`* Add the State Building Code Division <br /> Surcharge to each permit. �-`7 3�� x .0005 $ '. 3�0 <br /> or $.50, whichever is greater (contract price) <br /> 3. Postage and Handlin� (Only mail-in applications) $ 1.50 <br />;'' TOTAL PERMIT FEE (Add lines 1-3 above) $ �-7 �L, <br /> 4' vTT <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 /> ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or $.50 - whichever is greater. <br /> 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 all <br /> work in strict accordance with the ordinances e City and the regulations of the Minnesota <br /> State Building Code, and certifies that all s e s ade on this application are complete, true <br /> and correct. <br /> A licant's Si nature: � ���- Date: �p �1,�� <br /> PP g �� <br /> Approved By: Date: <br /> e.� <br /> .;:Y <br /> , <br /> > j; . 5 � <br />�.�,_�.� ..,..�_a� .._ ... _ . .. _ . _..�u._ .... ,_.._�,w� .�... .�;:,��:w . ,... , .. y _ - _ _ _,.._�.t� ��: .d�__..E.o,s.,. ...,�,._. <br />