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<br /> *WOOD BIIRNING EQIIIPI�NT $15.00 each unit
<br /> Wood stove with flue
<br /> Wood combination or add-on unit
<br />'�' Factory fireplace with flue
<br /> Factor Fireplace (s) freestanding _� i�tasonry-
<br />¢k Wood Stove (s ) franklin, other
<br />�` Brand Name Mode l No.
<br /> Mfgr' s Min. , Clearances, side .� ' , rear ..? �' , min. flue dia. f- x i �
<br /> Total
<br />�`"` *******************************************************************************�r
<br /> , VENTILATION $15. 00 each project
<br /> ,:
<br />;�;:r, No. Ritchen Exhaust ducted recirculating cfm
<br /> No. Bath Exhaust (must be ducted outside) cfm
<br /> No. Other Fans: Locations cfm
<br /> Total
<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 ��� o � � Gas opening
<br /> ********************************************************************************
<br /> GAS LINE INSPECTION
<br /> High/Low Pressure $15.00
<br />::4. ***,t***************************,t*******,t*************�tr****,t*********************
<br /> - PERMIT FEE CALCIILATION
<br /> ti.` l. 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 /> 3. Postaqe and Handling on all mailed-in applications, $ 1. 50
<br />�.' 4. TOTAL PERMIT FEE add lines 1-3 above $
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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 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.
<br /> ` )� � - �- �t �
<br /> Applicant' s Signature: �" \ � � � ��"`���--� Date:
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