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�,^� � .�:; n, �^-�--�r < �-�' .�, .°-.-;4s*�+-, .,,�,�,,. z� e <br /> . _ �� <br /> _ , . <br /> : <br /> . . "._ .t� <br /> . , a i : '�v� <br /> ��• <br /> .. _ � <br /> FIREPLACES t� <br /> -+i► . � <br /> Gas factory fireplace ' � <br /> ood burning factory fireplace with flue ,� <br /> ood Stove ;,� <br /> ood stove with flue '.':� <br /> '� <br /> Brand Name Model No. ,:� <br /> `��a <br /> ;�� <br /> VENTILATION �� <br /> No. Kitchen Exhaust ducted recirculating cfm � <br /> No. Bath E�aust (must be ducted outside) cfm �'' <br /> �x <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 /> :�� <br /> PERMIT FEE CALCULATION '� <br /> � <br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.00) '�� <br /> 3�00 , oo X .o12s $ 4 �1 , 5� <br /> (contract price) <br /> 2. State Surchar�e. ** Add the State Building Code Division <br /> Surcharge to each permit. 3�00 � 0 C� x .0005 $ � e q a <br /> or $.50, whichever is greater (concracc price) `'��; <br /> i: <br /> .� <br /> 3. Posta�e and Handlin� (Only mail-in applications) $ 1.50 '�� <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ _�� <br /> ��� :� <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 customer <br /> fer tne work done. lf any material, equipment, labor, or installation are furnished by the owner, tenant or ,�'' <br /> �:, <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 /> �f: <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 undersiQned 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: 0 � <br /> Approved By: Date: <br />�� <br />