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, . <br /> _ ._ , , . . . _, ___ . , - -- - - -- <br /> ,. _ . : : . . _ _ . ::.. <br /> , _ ._. „ . :: . . : 'r <br />*WOOD BIIRNING EQIIIPMENT $15.00 each unit <br /> Wood stove with flue <br /> Wood combination or add-on unit <br /> Factory fireglace with flue <br />?actor Fireglace (s) freestanding Masonry- <br /> 400d Stove (s ) franklin, other � <br /> 3rand Name Mode 1 No. <br /> dfgr's Min. , Clearances, side , rear , min. flue dia. <br /> Total <br /> k**�k***�t**********�Ir*******�k�t*�k*****�k*7t********atrak�t*�k*********�k#�t**ir**�c********�t** <br /> 7ENTII.ATION $15.00 each project <br /> 10. Ritchen Exhaust ducted recirculating cfm <br /> 10. Bath Exhaust (must be ducted outside) cfm <br /> 10. Other Fans: Locations cfm <br /> Total <br /> r******************************************************************************* <br />?UEL 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 /> cat�k�c*�k***ir***�c�t**�t�F****�k�t***�c*********�F*ir*******************ic**�k*ic�Y*****�k******* <br />�S LINE INSPECTION <br /> iigh/Low Pressure $15. 00 <br />:******************************************************************************* <br /> P$RMIT FEE CALCIILATION <br />.. Total of above Installations or Minimum Fee ($30.00) $ <br />! . State Surcharge. Add the State Building Code Division <br /> Surcharge to each permit $ . 50 <br />� . Postaqe and Handling on all mailed-in applications, S 1. 50 <br />�. TOTAL PERMIT FEE add lines 1-3 above $ <br />'he undersigned hereby applies to the City of issuance of a Mechanical Permit, f ' <br />�grees to do all work in strict accordance with the ordinances of the City and <br />:he regulations of the Minnesota State Building C.ode, and certifies that all ; = <br />�tatements made on this app lication are complete, true and correct. : <br /> � : <br /> • E [ <br />,pplicant' s Signature: x-�� ` ��� � - Date: �� Z"7 %�� � <br />� <br /> ; ` <br />