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<br /> � ' *WOOD BDRNING EQIIIPI�NT $15.00 each unit -
<br />�'�` Wood stove with f lue
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<br />�A" Wood combination or add-on unit �r" r>
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<br /> � Factory fireFlace with flue af
<br />�" Factor Fireplace (s) freestanding Masonry -
<br /> '� Wood Stove (s) franklin, other
<br /> BrandName Model No.
<br /> � Mfgr's Min. , Clearances, side , rear , min. flue dia.
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<br />� Total
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<br />°�� VENTILATION $15.00 each project
<br />��:
<br />�'- No. Ritchen Exhaust ducted �recirculating cfm
<br />° ` cfm t. ..
<br /> % No. Bath Exhaust (must be ducted outside)
<br /> s�
<br />�� No. Other Fans: Locations cfm
<br />. .
<br /> ry�� Total
<br />�:,, *******************************************************************************
<br />�� FUEL STORAGE (must be approved by fire marshal)
<br />�`,= .
<br />��. $30. 00 Permanent/Tem orary
<br /> xFuel oil, ���vv gallons �� underground inside � outside
<br />"'� LP Gas, gallons
<br />� Other Gas opening
<br /> -�
<br /> ****************************************************************************
<br /> ` GAS LINE INSPECTION
<br /> �� High/Low Pressure $15. 00
<br />:�.>;� *****************,t*********************,t*,�r*******,t****************************�
<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 rt"
<br />�'`' 3. Postaqe and Handling on all mailed-in applications, S 1. 50 �`�� ,,
<br />�` 4 . TOTAL PERMIT FEE add lines 1-3 above S
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<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
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<br />'>° the regulations of the Minnesota State Building Code, and certifies that a
<br /> ry;; statements made on this appl�ation are complete, true and correct.
<br />��. � / Date: ���'l"` / �� r
<br />. . AFplicant s Signature:
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