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- <br /> Tr <br /> aA - A m <br /> *WOOD BURNING EQUIPMENT $15. 00 each unit <br /> Wood stove with flue - w <br /> Wood combination or add-on unit .: <br /> Factory fireplace with flue <br /> At: <br /> Factor <br /> Factor Fireplace (s) freestanding built-in <br /> Wood Stove (s ) franklin, other <br /> Brand Name 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 /> FUEL 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 Gas opening <br /> GAS LINE INSPECTION <br /> High/Low Pressure $15 . 00 <br /> ***********'k****************** <br /> PERMIT FEE CALCULATION <br /> 1 . Total of above Installations or Minimum Fee ($30.00) $ p.p O <br /> 2 . State Surcharge. Add the State Building Code DivisionY <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 $ Ak- . ­ <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 /> ,W the regulations of the Minnesota State Building Code, and certifies that all <br /> statements made on this application are complete, true and correct. <br /> Applicant' s Signature: d � Date /6 --i/ <br /> f$ __ <br /> t <br /> z t ��r <br /> y g u st <br /> t4 , <br />.*,, i i IN <br /> 4 IX <br /> .fit '', <br />