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_ �,� _ . ' <br /> . � <br /> WOOD BURNING EQUIPMENT <br /> Wood stove with flue <br /> Wood combination or add-on <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., Clearances, side , rear , min. flue dia. �� <br /> ,� <br /> VENTILATION �` <br /> ; <br /> No. Kitchen Exhaust ducted recirculating cfm <br /> No. I3ath ��haust (must be �uctec? cutsidP) cfm <br /> No. Other Fans: Locations cfm <br /> FUEL STORAGE (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 Minimum�'ee ($35.00) —� _ <br /> `/��`��=�. -- x .0125 $ �.-7J���� <br /> (contract price) <br /> 2. State Surcharge. ** Add the State Buildmg Code Division <br /> Surcharge to each permit. `i<.��%, x .0005 $ ` ��� <br /> or $.50, whichever is greater (contract price) <br /> ,£ <br /> =��,; <br /> 3. Posta�e and Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ �� �.C"� �? <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 ior 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 />� <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 <br />'��� State Building Code, and certifies that all statements made on this application are complete, true <br />'�` and correct. � <br /> � , � <br /> ? �7 � .-. <br /> � Applicant's Signature: ��% � �' ��/ � � Date: ���� �� <br /> :'; <br /> Approved By: � Date: 3 ��'� <br /> . - � <br /> . , - _ - <br />