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<br /> # ,�'s8� a �� � r b a,,� '�-:_ •..z:3 . . �,L��
<br /> $ :+' t 33 q . � �b. Ra 'f� k � °'�..� t
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<br /> =� *WOOD BIIRNING EQIIIPMENT $15.00 each unit ''
<br />��` Wood stove with flue '
<br /> Wood combination or add-on unit '
<br /> Factory fire�lace with flue ' ;
<br /> Factor FireFlace (s) freestanding � Masonry f;
<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 /> ,�
<br /> �.
<br /> No. Ritchen Exhaust ducted recirculating cfm t� ' i, �..';� �;°.„ '•
<br /> No. Bath Exhaust (must be ducted outside) cfm - ;
<br /> No. Other Fans: Locations cfm `��
<br /> Total �'a
<br /> ******************************************************************************** ��
<br /> FUEL STORAGE (must be approved by fire marshal) `�}
<br /> ' $30. 00 Permanent/Temporary � �
<br /> Fuel oil, gallons underground inside outside �,, x� ,s '�y�
<br /> LP Gas, gallons � ��`
<br /> � �¢
<br /> Other Gas opening '�
<br /> ********************************************************************************
<br /> GAS LINE INSPECTION `
<br /> High/Low Pressure $15.00 �
<br /> ******************************************************************************** "�
<br /> P$RMIT FEE CALCIILATION �
<br /> 1. Total of above Installations or IrSinimum Fee ($30.00) $ ,� v�
<br /> 2 . State Surcharge. Add the State Building Code Division °- �; ��
<br /> Surcharge to each permit } '�" e' A
<br /> $ 1. 50 �` � ��x �
<br /> 3. Postaqe and Handling on all mailed-in applications, ��� ��V
<br /> 4. TOTAL PERMIT FEE add lines 1-3 above $ ��
<br /> �
<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 />��
<br /> statements made on this ap ication are complete, true and correct. �
<br /> �
<br /> f y � 4, , �
<br /> Applicant' s Signature: C Date: �!/��� ^l� : ,� � ��
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