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<br /> *WOOD BIIRNING EQIIIP1�iT $15.00 each unit � ����; }
<br /> Wood stove with f lue � u$��� ' �\
<br /> � : � �x,
<br /> Wood combination or add-on unit �: �� � ��� ���� �,
<br /> Factory fire�lace with flue ' ' � �
<br /> Factor Fireplace (s ) freestanding Masonry ���
<br /> �»�
<br /> Wood Stove (s ) franklin, other ,� �;
<br /> Brand Name Mode 1 No.
<br /> Mfgr' s Min. , Clearances, side , rear , min. flue dia. �^
<br /> Total �,-'
<br /> ********************************************************************************
<br /> VENTILATION $15. 00 each project �
<br /> k�
<br /> No. Ritchen Exhaust ducted recirculating cfm � .� ; ,.� ����
<br /> No. Bath Exhaust (must be ducted outside) cfm �a�.��•.t " ��"�
<br /> No. Other Fans: Locations cfm
<br /> Total �
<br /> ******************************************************************************** ,�
<br /> �
<br /> FIIEL STORAGE (must be approved by fire marshal)
<br /> ' $30. 00 Permanent/Temporary
<br /> � Fuel oil, gallons underground inside outside ;�
<br /> LP Gas, gallons '
<br /> �x
<br /> Other Gas opening ;
<br /> ******************************************************************************** �
<br /> _:
<br /> GAS LINE INSPECTION
<br /> High/Low Pressure $15. 00 �
<br /> ******************************************************************************** ����,
<br /> PBRMIT FEE CALCIII,ATION e� ;�`;
<br /> 1. Total of above Installations or Minimum Fee ($30.00) $ 3� '-� �
<br /> 2. State Surcharge. Add the State Building Code Division t '���-��� "�
<br /> $ . 50 �� Q� "
<br /> Surcharge to each permit �T_� _ ,,��k�
<br /> 3. PostaQe and Handling on all mailed-in applications, S «�.g¢�.-��,�
<br /> 4. TOTAL PERMIT FEE add lines 1-3 above $ '� o �." `�
<br /> _ ti�
<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 /> statements made on this app lication are complete, true and correct.
<br /> ; �Z � ��
<br /> ' Applicant' s Signature: � �,-„N,,� �i. � �ir���-Y Date: � -�`l �� � �a
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