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�� �� � <br /> i <br /> �� i: <br />� _ <br /> *WOOD BIIRNING EQIIIPI�NT $15.00 each unit <br /> Wood stove with flue <br /> Wood combination or add-on unit <br /> Factory fireglace 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 /> ******************************************************************************** <br /> VENTILATION $15.00 each project <br /> No. Kitchen Exhaust ducted recirculating cfm <br /> �;o. �^;, Bath Ex�aust (must be ducted outside) cfm <br /> No. Other Fans: Locations <br /> Total <br /> ******************************************************************************** <br /> FUEL STORAGE (must be approved by fire marshal) <br /> ' $30. 00 Permanent/Temporary <br /> Fuel oil, gallons underground inside outside <br /> LP Gas, gallons <br /> Other Gas opening <br /> ******************************************************************************** <br /> GAS LINE INSPECTION - `�� <br /> High/Low Pressure $15.00 �� <br /> ********�r**�t:�x�x�s�s��r��r�*��**��************************************************** <br /> P$RMIT FEE CALCIILATION �� <br /> 1. Total of above Installations or Minimum Fee ($30.00) $ . -�J. <br /> 2. State Surcharge. Add the State Building Code Division $ .50 <br /> Surcharge to each permit $ 1.50 <br /> 3. Postage and Handling on all mailed-in applications, <br /> 4. TOTAL PERMIT FEE add lines 1-3 above $ �J'� �"L� <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 and <br /> the regulations of the Minnesota State Building Code, and certifies that all <br /> state�rien�s naue on t?:is aFr li.�at�-on are complete, true and correct. <br /> , <br /> .� ,. <br /> � �._ /�/�/�j Date: „� %�; "��� <br /> A�p licant' s Signature: ���� •� <br /> �> � <br />: • � � . <br /> � : . <br /> . • <br />, � � <br />,. ;. � _ <br />�� � <br /> � . <br /> , <br /> � <br />