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'i ,; z'y.,, <br /> "T �g� i t k+ S'��t kz' it M S�" +'` �'�^•' 2 S.t � e;� <br /> E# ,i, <br /> ..tA � � t♦ i,- 4 iRi <br /> Y y <br /> *WOOD BURNING EQUIPMENT $15. 00 each unit <br /> Y a <br /> Wood stove with flue . <br /> Wood combination or add-on unit <br /> Factory fireplace with flue <br /> Factor Fireplace (s ) freestanding built-in <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 /> 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 /> PERMIT FEE CALCULATION <br /> 1 . Total of above Installations or Minimum Fee ($30.00) $ ,19,06 <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 $ 3,-t.UZ� <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 R <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 /> x�ti <br /> Applicant' s Signature: r Date: ,1Y <br /> 61 <br /> Gly <br /> H« ,, <br /> R� 'WF .1 �!Y 'Tt 1R• ..F Y <br /> aA�i' R >at <br /> �. k <br /> A <br /> € i , y <br /> 'rs sir S . ; <br /> Ai. <br /> . red <br /> sz <br />