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. . . . . . i � �-.:i . ... . ..� ... � <br /> i :.: . . .:.s . ... . ..—.. . . .. ... . .. . . . . . <br /> �•.�� � �� �" , :. ' '.'�� ��..�. �� . . . . . . � . . - . <br /> ��� .. . .. . �.���% � � � � .. ' . . . .. � � . ' � , � <br /> WOOD BURNING EOUIPMENT <br />`' Wood stove with flue <br />� .:: <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 /> k:.: Mfgr's Min., Clearances, side , rear , min. flue dia. <br />�`: <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 />�, <br />� FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) <br />�" <br />��' Installation Removal <br />�� <br /> k° Fuel oil: gallons underground inside outside <br />�`` LP Gas: gallons <br />�4;' Other Gas opening <br />�=" PERMIT FEE CALCULATION <br />�� 1. 1.25% of Contract Price* or Minimum Fee ($35.00) <br />�' a000. c�d X .oi2s $ 3s. o � <br />�: <br />� (contract price) <br />�' 2. State Surchar�e. ** Add the State Building Code Division <br /> Surcharge to each permit. x .0005 $ � . C� � <br /> :� <br /> or $.50, whichever is greater (contract price) <br /> s 3. Posta�e and Handling (Only mail-in applications) $ 1.50 <br /> � 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ 3 '7.. S O <br /> �;, <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 pemut 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 />�-,` <br /> State Building Code, and certifies that all statements made on this application are complete, true <br />�; <br /> and conect. <br />�-�� . <br />��: Applicant's Signature: Date: �� <br /> Approved By: Date: <br />``� <br /> ,., , . <br /> � . <br /> , _ . <br />..a..�: , � , - _ <br />