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,�: .�. � <br /> . .! <br /> � . <br /> � <br />.a . � .. . ... .. . <br /> i . <br /> ,. � . . .�. � ��i:: . <br />`, . . . .. . . . <br /> sr'. <br />� *WOOD BIIRNING EQIIIPI�NT $15.00 each unit <br /> f�; <br /> Wood stove with flue <br /> Wood combination or add-on unit <br />�: Factory fireFlace with flue <br />`'` Factor Fireglace (s) freestanding Masonry <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 /> r No. Kitchen Exhaust ducted recirculating cfm <br />� ' No. = Bath Exhaust (must be ducted outside) �<� cfm <br />� _' No. Other Fans: Locations cfm ���> <br /> Total �s <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 /> Other Gas opening <br /> ******************************************************************************** <br /> GAS LINE INSPECTION <br /> High/Low Pressure $15. 00 <br /> , ************************************************************�r******************* <br /> P$RMIT FEE CALCULATION �c <br /> 1. Total of above Installations or Minimum Fee ($30.00) $ �U � <br /> 2 . State Surcharge. Add the State Building Code Division = <br /> Surcharge to each �ermit $ . 50 � <br /> ' 3 . Postaqe and Handling on all mailed-in applications, $ 1.50 r: <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 and <br /> the regulations of the Minnesota State Building Code, and certifies that all <br /> statements made on this app lication are complete, true and correct. <br /> � � V�-'�-'i/V V� Date: r�h 1 l 1°!1'�-- <br /> A� licant s Si nature: ��1,'l�- <br /> _P g <br /> - { '{ <br /> � <br /> } <br /> � <br /> � ' � . <br /> , � <br />�� , <br />�, <br /> � <br />;, ; � <br />�., ; . . <br />°f � I � �� � � <br />€. �, � <br /> ! <br /> . <br />:' <br /> - ,,:. � , e �._ <br />