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4 ....,s ? -}. l q.,it.:
<br /> � �
<br /> �� � � .�
<br /> .+'��. .. 3.. .
<br />� � * $15.00 each unit � �
<br /> WOOD BIIRNING EQIIIPMENT ;
<br />� Wood stove with f lue ,,�,
<br />� Wood combination or add-on unit �
<br /> Factory fireFlace with flue
<br />� Factor Fireplace (s) freestanding Masonry . �
<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 /> Es *******************************************************************************
<br />{` VENTILATION $15.00 each project
<br /> No. Kitchen Exhaust ducted recirculating cfm
<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
<br />� ;� Fuel oil, gallons underground inside outside
<br /> � LP Gas, gallons
<br /> � Gas opening
<br /> Other
<br /> **************************** **�,r**********************************************
<br /> LINE INSPECTION '� `"�""" ��' Jp�-� �� ����
<br /> High ow Pressure i �-� ^�"�" `���'i�`��$15. 00
<br /> * ************************ ********** ******* *****************************
<br /> PERMIT FEE CALCIILATION
<br /> l. 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. 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 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 /> � Q
<br /> Applicant' s Signature: �� Date: � U`� � ^ l��
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