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<br />�: $
<br />��' *WOOD BIIRNING EQIIIPI�NT $15.00 each unit ;
<br />�; Wood stove with flue '
<br /> �� Wood combination or add-on unit .t� �� �
<br />��,;
<br /> Factory fire�lace with flue k; � ,
<br /> r;:
<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 />�� VENTILATION $15.00 each project
<br />��` :
<br />� ' No. Ritchen Exhaust ducted recirculating cfm � �;
<br /> � t
<br /> �;��, No. Bath Exhaust (must be ducted outside) cfm
<br /> No. Other Fans: Locations cfm
<br />� Total
<br />�`' ******************************************,r�************************************�
<br /> a�' 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 /> �
<br /> � Other Gas opening
<br />�' ****************,r****************************it***********�F*********************�
<br /> r:
<br /> NE INSPECTION
<br />'�:�Y High ow Pressure $15. 00 �
<br /> ��.: *** ****************************************************,t**********************
<br />�`` PERMIT FEE CALCIILATION
<br />��i
<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. Postage and Handling on aIl mailed-in applications, $ 1.50 ..���a
<br />��� 4. TOTAL PERMIT FEE add lines 1-3 above $
<br />�,,.
<br />�
<br />,r�. 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 />"y� the re ulations of the Minnesota State Building Code, and certifies that all
<br />,:�..
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<br />�T� statements made on this app lication are comglete, true and correct.
<br /> �
<br />�`
<br /> l�� �� � �
<br />�'�� ,� �'q1/%2�,, �- Date: v'� �C5 �
<br />` � Applicant' s Signature: , �
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