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<br />: `� *WOOD BIIRNING EQIIIPMENT $15.00 each unit .,
<br />� ; Wood stove with flue
<br />�w� � Wood combination or add-on unit
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<br /> Factory fireplace with flue
<br /> °=j Factor Fireplace (s) � freestanding Masonry --
<br /> Wood Stove (s ) franklin, other
<br /> -i Brand Name Mode 1 No.
<br /> `�' Mfgr's Min. , Clearances, side , rear , min. flue dia.
<br /> Total
<br /> ********************************************************************************
<br /> VENTILATION $15.00 each project
<br /> No. Ritchen Exhaust ducted recirculating cfm
<br /> No. Bath Exhaust (must be ducted outside) cfm
<br /> No. Other Fans: Locations cfm
<br /> **�*�*�*x**��*****�*��,��*!***#*****�;�*��*�*���**********************
<br />`" FII$L 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 I,INE INSPECTION
<br /> a High/Low Pressure $15. 00
<br /> �*********���:�*�**,�***�*********************************.************************
<br /> ,. �-,.� :.
<br /> P$RMIT FEE CALCULATION
<br /> 1. Total of above Installations or Minimum Fee ($30.00) $_�� � C' CU
<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, 0
<br /> i 4. TOTAL PERMIT FEE add lines 1-3 above $�7: i:� �
<br />� � The undersigned hereby applies to the City of issuance of a ec anical Permit,
<br />�; t; 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 application are complete, true and correct.
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<br /> A licant' s Si nature: J �� / LZ�'f��- Date:
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