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<br />"�" *WOOD BIIRNING EQIIIPMSNT $15. 00 each unit �
<br />�� , ,
<br /> ' Wood stove with flue
<br />��'' Wood combination or add-on unit
<br />���' Factory fire�lace with flue
<br />��, Factor Fireglace (s ) freestanding Masonry �
<br />`�fi; Wood Stove (s ) franklin, other '�
<br />� BrandName Model No.
<br />�`� Mfgr' s Min. , Clearances, side , rear , min. flue dia.
<br />�k Total
<br />�f.: *******************************************************************************
<br />'��� 15.00 each ro ect
<br />�'`�; VENTILATION $ P J
<br />��,
<br />�' No. Kitchen Exhaust ducted recirculating cfm
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<br />��' No. Bath Exhaust (must be ducted outside) cfm �,.
<br />�� No. Other Fans: Locations cfm
<br />� Total
<br /> *******************************************************************************
<br /> FIIEL STORAGE (must be approved by fire marshal)
<br /> ' $30. 00 Permanent/Temporary , .�t
<br /> Fuel oil, gallons underground inside outside t;
<br /> .�
<br /> LP Gas, gallons
<br />�' Other Gas opening
<br />��;, *******************************************************************************�
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<br />�,,,>; GAS LINE INSPECTION
<br />� „ High/Low Pressure $Z5 . 00
<br />.�,, �*�t********��*y***�*t�t�*******************************************************•
<br />`��` p$RMIT FEE CALCIILATION
<br /> �'
<br />��` 1. Total of above Installations or Mini.mum Fee ($30.00) $ :k*�� c�� �
<br /> �¢.4 #
<br />� 2. State Surcharge. Add the State Building Code Division
<br /> .50 i
<br />��''' Surcharge to each permit $ �� �
<br /> 3 . Postaqe and Handling on all mailed-in applications, $ 1. 50 ' �
<br />� 4 . TOTAL PERMIT FEE add lines 1-3 above $ _� : _ _
<br />�� 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 anc
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<br /> � the regulations of the Minnesota State Building Code, and certifies that al _
<br />���`� statements made on ti��is app lication are comp lete, true and carrect.
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<br />� AFPlicant' s Signature: �" ;,�-- _��- �\ ! Date: `!-i6��-�:r �"���<�R
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