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MAY7.:30-2000 TUE 02: 18 PM P. 007 <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 /> No. Kitchen Exhaust ducted recirculating _-� cfm <br /> No. Bath Exhaust (must be ducted outside) cfm <br /> No. Other Fans: Locations cfm <br /> FUEL $TQ iGE (MUST BE APPROVED 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 Nttnimum Fee ($35.00) <br /> 44L0 -�I°I�.oC") x .0125 $ 5 -1.°v-I <br /> (contract price) <br /> 2. State,Surcharge, ** Add the State Building Code Division <br /> Surcharge to each permit. 146.1q5.00 x .0005 $ "423.410 <br /> or 5.50, 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) $ b()8. 3'I <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 SURCHAROE is .0005 of the contract price under$1,000,000 or $.50•whichever is greater. <br /> Por 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 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 /> Applicant's Signature: Date: / e <br /> Approved By: Date: 6 1-0c) <br />