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i . . T� ����,�a .. r .-�,.� . . , .. . - , . . .. .�'�. <br /> 1. . . . � . � . .. �. . <br /> i <br />��� � i �� � � �� 1 .� .. <br /> # <br /> � , , _ <br /> *WOOD BIIRNING EQIIIPMENT $15. 00 each unit <br />�.°=:' Wood stove with f lue <br /> Wood combination or add-on unit <br /> Factory fireFlace w th flue <br /> Factor Fireplace (s ) freestanding Masonry. ��j <br />�nV; Wood Stove (s ) franklin, other <br />�` BrandName Model No. <br />�� Mfgr' s Min. , Clearances, side , rear , min. flue dia. <br /> Total <br /> ri` ******************************************************************************** <br /> VENTILATION $15.00 each project <br /> ,� No. _� Kitchen Exhaust ducted recirculating cfm <br />�` No. �_ Bath Exhaust (must be ducted outside) cfm ; <br />„;;: <br /> ��; No. Other Fans: Locations cfm ; <br />� Total �� <br />µP��..' ****Ilc*7F*7k*1k*7Y**�C*�c****ic7t****7F7k***71'7f7k**********IC*7k*7k******!t*****7k**7k***�c*7k***7t**7t <br /> a�' FIIEL STORAGE (must be approved by fire marshal) �� <br /> a�, • <br />���- $30. 00 Permanent/Temporary <br />� Fuel oil, gallons underground inside outside <br />� LP Gas, gallons <br /> Other Gas opening <br /> ******************************************************************************** <br />� GAS LINE INSPECTION ✓ <br />`� High/Low Pressure $15. 00 <br />�`� ************************************************************x******************* <br /> PERMIT FEE CALCULATION <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 />� $ 1.50 <br /> 3. Postaqe and Handling on all mailed-in agplications, <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 /> R:; <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 a <br /> y?°; statements made on this application are complete, true and correct. <br /> i;�� <br />� <br /> AFplicant' s Signature: Date: s�9� <br />��� <br /> � <br /> � i ' <br /> f <br /> ; <br /> � i , i - <br /> � � ' � s �:; <br /> cr� a.: ', t <br /> �, 1 " <br /> �� � ��. , '�.�� � � .. � 4� <br /> ; ' <br /> � 1. 5. <br /> a t # , � . ... . :�'3,$� . <br /> S �, <br /> �e <br /> � w <br /> ,�:, � . . . �. ���.�R�� � <br /> � � .. � . . . . � . .� � � � � � . . � . ��1 <br /> �� F <br /> � � � <br /> �: r <br /> s,l , . ._ . .. .. ... . '�t, .�..s' . �, � ... . . . . . . . � � . _ � � - . � . . . - .. '�=�s <br />