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� <br /> *WOOD BDRNING EQIIIPMENT $15.00 each unit <br /> Wood stove with flue <br /> Wood combination or add-on unit <br /> Factory fire�lace with flue <br /> Factor Fireplace (s) freestanding Masonry <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. Ritchen Exhaust ducted recirculating cfm <br /> No. Bath Exhaust (must be ducted outside) cfm <br /> No. Other Fans: Loca�ions �fm <br /> Total <br /> ******************************************************************************** <br /> FUEI, 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 $15. 00 <br /> **�*****�*x*xxx�x*��***��*�***�**��x******�*�**�*x*****x******xx****x*�********* <br /> P$RMIT FEE CALCD'i�'ATI�ON• ' - <br /> 1. Total of above Installations or Minimum Fee ($30.00) $ `? � C C� <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, S 1.50 <br /> 4. TOTAL PERMIT FEE add lines 1-3 above $ 3 =� :�, D <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 tha� all <br /> statements made on this app lication are complete, true and correct. <br /> Applicant' s Signature: �� Q -� � e -��.Q Date: `�� (�� �� �. <br /> � �� �� / <br />