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� v...� -- --- .. <br /> OCT �. g �i9�3 <br /> *WOOD BIIRNING EQIIIPMSNT $15.00 each unit <br /> Wood stove with f lue <br /> Wood combination or add-on unit <br /> �_Factory fire�lace with flue � '"� '' <br /> ., -. <br /> Factor Fireglace (s) freestanding MasQnry <br /> Wood Stove (s ) franklin, other <br /> BrandName '« Model No. 5 �/ <br /> Mfgr' s Min. , C1 arances, side � z�' , 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 outsidei •:f•�� <br /> No. Other Fans: Locations cfm <br /> Total <br /> ******************************************************************************** <br /> FIIEL 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 $15. 00 <br /> ******************************************************************************** <br /> P$RMIT FEE CALCULATION <br /> 1 . Total of above Installations or Mini.mum Fee ($30.00) $ ��• �O <br /> 2 . State Surcharge. Add the State Building Code Division <br /> Surcharge to each permit $ . 50 <br /> 3 . Postaqe and Handling on all mailed-in applications, $ 1. 50 <br /> 4 . TOTAL PERMIT FEE add lines 1-3 above $ � .(�3 <br /> The undersigned hereby applies to the City of issuance of a Mechanical Permit, 3 <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 applicatio are comglet , true and correct. ' <br /> �__._`: <br /> � � �J Date: �J: �- <br /> Applicant s Signature: <br />