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*WOOD BURNING EQUIPMENT $15. 00 each unit <br /> Wood stove with flue <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 /> 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 /> ******************************************************************************** <br /> GAS LINE INSPECTION <br /> High/Low Pressure $15. 00 <br /> ******************************************************************************** <br /> PERMIT FEE CALCULATION � y�o� <br /> 1. Total of above Installations or Minimum Fee ($30.00) $ 3f' <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, $ 4-144)— J9 <br /> 4. TOTAL PERMIT FEE add lines 1-3 above $ " <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 /> statements made on this app : ation are complete, true and�` correct. <br /> ` /1 Date: / l zl�d <br /> Applicant' s Signature: L� <br /> OF <br />