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<br /> *WOOD BIIRNING EQIIIPMENT $15. 00 each unit ; �f�
<br /> Wood stove with flue
<br /> Wood combination or add-on unit ��
<br /> Factory fireFlace with flue n
<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.
<br /> Total
<br /> ********************************************************************************
<br /> VENTILATION $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 /> ��:
<br /> FUEL STORAGE (must be approved by fire marshal) T='
<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 ���yZ�
<br /> High/Low Pressure �� /� " *�� �-,-`, `x��fi , (����, 0
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<br /> PERM�T FEE CAI�CIYI TION
<br /> 1 . Total of above Installations or Minimum Fee ($30.00) $ ?�T C�;
<br /> 2 . State Surcharge. Add the State Building Code Division
<br /> Surcharge to each permit W._ . _.._.,..�.._ . 50 ' ��
<br /> 3 . Postaqe and Handling on all mailed-in applicati„q1'iS,,,,.��....__.� .. 1. 50
<br /> 4 . TOTAL PERMIT FEE add lines 1-3 above � � �� ' $ =���� _
<br /> ihe 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 /> t�.� Yor„ i a�; �ns of_ the Minnes�t-a State Buildinq Code, and certifies that al l
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<br /> statements made on this application are complete, true and correct.
<br /> A licant' s Signature: � �, �=� Date: j- ��i � � �"���
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