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<br />��r'� *WOOD BIIRNING EQIIIPI�N'P $15.00 each unit
<br /> Wood stove with flue
<br /> �� Wood combination or add-on unit �
<br />.,�;
<br /> �.� Factory fireFlace with flue �
<br /> � Factor Fireplace (s) freestanding X Masonry - ''
<br />��� Wood Stove (s ) franklin, other
<br />��;
<br /> Brand Name Mode l No.
<br /> � Mf r' s Min. , Clearances, side , rear , min. flue dia. /�.�ia
<br /> �' g Total «,,,. �._
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<br /> ********************************************************************************
<br />�� VENTILATION $15.00 each project
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<br /> 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 />��;
<br />�,:, Fuel oil, gallons underground inside outside
<br />�:; LP Gas, gallons
<br />�,_;,,
<br /> Other Gas opening
<br />� ********************************************************************************
<br />���` GAS LINE INSPECTION
<br /> High/Low Pressure $15. 00
<br />�-� ********************************************************************************
<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 �'
<br /> � 3. Postage and Handling on all mailed-in applications, $ 1.50
<br /> .�;� 4. TOTAL PERMIT FEE add lines 1-3 above $ _
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<br /> F� 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 ap cation are complete, true and correct.
<br /> �� -
<br /> � Applicant' s Signature: ��/ `'`�� Date: � �� �� 3
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