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� <br /> _ �,. ,� <br />�., *WOOD BDRNING EQIIIPMSNT $15.00 each unit <br /> Wood stove with flue <br /> Wood combination or add-on unit <br /> Factory fireplace with flue <br />�+' Factor Fireplace (s) freestanding Masonry <br /> ` Wood Stove (s ) franklin, other <br />�' BrandName Model No. <br />�� Mfgr' s Min. , Clearances, side , rear , min. flue dia. <br /> Total <br />.F.'_ yy y yyyyyJ.y.L,yyyy y y y ,y .LJ.y y.L.Y J.y y yy y y y.L y1.L.L.Lyyy.L.L y y,,y y yyy yi.y.L.L y y .L.L <br /> � �f n i�if i�i��C iG if�G iC i{i�i�il T J��{i{�i�f��T iC T���C�n R T T n n��f T�if i�T�i���T�ii i��i��4]�l��l�G l�T ii I�i�i�iC�T i�T T T T i{�C li�C i��ii Jf <br /> VENTILATION $15. 00 each project <br /> ° No. Kitchen Exhaust ducted recirculating cfm <br />��« <br /> � No. Bath Exhaust (must be ducted outside) cfm <br />"`�`: No. Other Fans: Locations cfm <br /> Total <br /> **************************************************************,r***************** <br /> FIIEL STORAGE (must be approved by fire marshal) <br />,;:;, . <br /> $30. 00 Permanent/Temporary <br /> Fuel oil, gallons underground inside outside <br /> LP Gas, gallons <br />� Other -, - � z:--�-- Gas opening <br /> ****************************** ************************************************* <br /> ' GAS LINE INSPECTION <br />�,� High/Low Pressure $15.00 <br /> ******************************************************************************** <br /> P$RMIT FEE CALCULATION <br /> 1. Total of above Installations or Minimum Fee ($30.00) $ <br /> 2. State Surcharge. Add the State Building Code Division <br /> Surcharge to each permit $ . 50 <br /> , 3. Postaqe and Handling on all mailed-in applications, $ 1. 50 <br /> ' 4. TOTAL PERMIT FEE add lines 1-3 above $ _ <br /> a,-, The undersigned hereby applies to the City of issuance of a Mechanical Permit, <br /> agrees to do all work in strict accordance with the ordinances of the City and <br /> the regulations of the Minnesota State Building Code, and certifies that all <br /> .= statements made on this application are complete, true and correct. <br />' < � -� <br /> ,� a <br />;��. Applicant' s Signature: - ������� � � Date: 7���-�/�2 <br />� � <br /> w . � <br /> � : � <br />�� ' �, . <br />� - <br />� t <br /> : � : : � . <br /> , : ` <br /> � <br />;� <br /> �. <br />�. �. . <br />