|
� �.,.,-,P. ..�., . .r
<br /> k. 1 ,�
<br /> r�,' , .�:,..
<br /> 1 , i �, '
<br /> i x . .
<br /> � .� � ,�
<br /> 4 3
<br /> F � � j�, �: � �'.
<br /> � .
<br />���. 4. ' yZ :'. �, 3 �.-
<br /> ` ' %
<br /> u �. , �
<br /> 9�,�._. 1 . �� � '� !
<br /> th� x.
<br />�� :�_:
<br />�• :
<br /> *WOOD BIIRNING EQIIIPMENT $15.00 each unit � ` z
<br /> Wood stove with f lue ��� , ���
<br /> Wood combination or add-on unit �:: �'`
<br /> " Factory fireplace with flue `�
<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 /> ' VENTII�ATION $15.00 each project
<br /> ��: No. Kitchen Exhaust ducted recirculating cfm ,
<br /> � No. Bath Exhaust (must be ducted outside) cfm
<br /> ,:
<br />��F No. Other Fans: Locations cfm
<br />�'' Tota1
<br />� ******************************************************************************** :
<br /> ` FIIEL STORAGE (must be approved by fire marshal) r;
<br /> �' ' $30. 00 Permanent/Temporary
<br /> ���; Fuel oil, gallons underground inside outside
<br /> LP Gas, gallons `f
<br /> � Other Gas opening
<br />�"� *********************************************************************,t********** e"'
<br />�
<br />�= GAS LINE INSPECTION
<br />�� High/Low Pressure $Z5. 00
<br /> � ********************************************************************************
<br />��``' PERMIT FEE CALCULATION
<br />�a
<br />�#� 1 . Total of above Installations or Minimum Fee ($30.00) $ , ;; �:
<br />��; 2 . State Surcharge. Add the State Building Code Division `�'�' i
<br />�'°` Surcharge to each permit $ . 50
<br /> �� � � ,,; ,���
<br /> T:
<br />��- 3. Postage and Handling on all mailed-in applications, S 1. 50 -
<br />"�": 4 . TOTAL PERMIT FEE add lines 1-3 above $
<br /> r�=>
<br />,�r:�.
<br /> r �
<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 :=3
<br /> '; statements made on this application are complete, true and correct.
<br />��;:
<br /> : ,,
<br /> �: /�
<br /> Applicant' s Signature: ` Date: G � �'
<br /> ,,:;� ��%.
<br /> ��" ;�;�
<br /> ' . �� �
<br /> �� + � ��
<br /> w.
<br />��,� :� , "� � � � �
<br />��J y ,�
<br />�§t tx rt . . . .. . .. .
<br />+"�;� ' �, � � � � - `'a�
<br /> ; ;�
<br /> �, .,;�
<br />�'°`�� �
<br />.��
<br /> ��:` j �
<br /> ��, -
<br />��;� �
<br /> �,.
<br /> �.
<br /> , t �
<br />�.�� � . - - � �
<br /> �, �, � t ,
<br />���* , - k �. , �= ' � s`��:��� {�
<br /> C�Xj s. � �� c . �c. t '� .� ,i3 �.
<br />.k��,+ �� ," � ` � �s + ��''` :�.� � �
<br />�`�� r ' � �� s * `h��� t
<br /> � r� }.
<br />�..e. _7. ....� , r,.§.i�r.<sl.�.�.n._�e_. ... . _ . . _. .. . _....�... ..u� . _ ...�.��..,, .v .... . ... ., . � . ..�...2...r..�. .. . ...,.. x,....
<br />
|