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� 1 <br /> 1 <br /> _ � <br /> *WOOD �?7RNING E�vIPMENT $15.00 each unit <br /> Wood stove with flue <br /> Wood combination or add-on unit <br /> Factory fireplace with flue <br /> Factor Fireplace (s) freestanding built-in <br /> Wood Stove (s ) fr�anklin, other <br /> Brand Name Mode I No. <br /> Mfgr' s Min. , Clearances, side , rear , min. flue dia. <br /> Total <br /> *******�******�***************************************************************** <br /> VENTII,ATION $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 /> FIII�L. _STORAGE (must be approved by fire marshal) <br /> $15. 00 Permanent/Temporary <br /> Fue2 oil, gallons underground inside outside <br /> LP Gas, gallons <br /> Other Gas opening <br /> ******************�r�*�*****************************�*********************#****** <br /> GAS Y�INL INSP$CTION <br /> High/Low Pres.sure $15.00 <br /> *****�*********�****************�**�******************************************** <br /> Pffi2MIT FEE CALCDLATION /� -U�' <br /> 1. Total of above Installations or Minimum .Fee. 0._00) $ ��•� <br /> 2. State Surcharge. Add the State Building Code Division <br /> Surch'arge to each permit $ _ .50 <br /> 3. Postac�e and Handling on alI mailed-in applications, $ 1.50 <br /> 4. TOTAL PERMIT FEE add lines 1-3 above $ ,,3��r� <br /> The undersigned hereby applies to the City of issuance of a Mechanical Permit, <br /> agrees to do alI work in strict accordance with the ordinance� of the City and <br /> the regulations of the Minnesota State Building Code, and certifies that all <br /> statements made on this application are complete, true and correct. <br /> � <br /> AppZicant's Signature: Date: �l �� � <br />