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<br /> *WOOD BIIRNING EQIIIPMSNT $15.00 each unit �'� `� ,�' � -
<br />,� Wood stove with f lue ,r fy'�
<br />�< Wood combination or add-on unit �
<br /> �._"
<br />'y�� Factory fire�lace with flue �
<br />"b1,
<br />�� Factor Fireplace (s) freestanding built-in ��
<br />�; Wood Stove (s ) franklin, other �
<br />�.� BrandName Model No. �
<br />�� Mfgr' s Min. , Clearances, side , rear , min. flue dia.
<br />� Total
<br />��' ******************************************************************************�
<br /> 15. 00 each ro ect
<br />�.u. VENTILATION $ P J
<br />�, T�� .�:
<br /> .� No. Kitchen Exhaust ducted recirculating cfm "; f���� ��
<br /> � ;:
<br /> ; No. Bath Exhaust (must be ducted outside) cfm �
<br />�K�" No. Othez F�ns: Locations cfm
<br /> Totai
<br />�� *******************************************************************************
<br />�a= FIIEL STORAGE (must be approved by fire marshal)
<br /> 4,.,
<br />��� " $30. 00 Permanent/Temporary
<br />� ,:
<br /> Fuel oil, gallons underground inside outside ��
<br />�`; LP Gas, gallons
<br />� Other Gas opening
<br />�n�
<br /> � *******************************************************************************
<br /> GAS I,INE INSPECTION
<br />�'' High/Low Pressure �15. 00
<br />��.
<br />��� �C�C�I'7�C*�C�C'k�C**�C tf�C****7�C*!f'�C**�f iC'�C�f 7F*'k**!�C�f 1F'�7�C t*:k 7�c�''¢f 1k:�!�f�c S�'!�7f!�''�.'�'1�:�C*i i i.�'k 7Z'�'7�SF'��'.'�'.�C!t�:.t'�.'�`''��"c�S
<br />���� PERMIT FEE CALCIILATION
<br />�� 1. Total of above Installations or Minimum Fee (530.00) $ .
<br /> >_� �
<br /> 2. State Surcharge. Add the State Building Code Division �
<br />�� Surcharge to each permit $ .50
<br /> 3: Postage and Handling on all mailed-in applications, S - -�-
<br />� 4 . TOTAL PERMIT FEE add lines 1-3 above $ -
<br /> -----------�
<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 an
<br /> the regulations of the Minnesota State Building Code, and certifies that al
<br />��; statements made on this app lication are complete, true and correct.
<br />� ' ,
<br />� .
<br /> P;� Applicant' s Signature: �������� �9���Q �Date: �-����� ���
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