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F <br /> *WOOD BIIRNING 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. y <br /> Total <br />******************************************************************************** <br /> VENTILATION $15 . 00 each project <br /> No. Kitchen Exhaust ducted recirculating cfm <br /> NO. Dd'Lli r;X�7c1Li5'i. �it'tt151. �C uuC�c� ^vutSiuei �%�^! <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 />��rx*�:r�*t�*1�r******��r***:t*****,t************************************************* <br /> PSRMIT FEE CALCULATION <br /> 1. Total of above Installations or Minimum Fee ($30.00) $ � 7.,�l� <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 $"� ��, �-cu <br /> Phe undersigned hereby applies to the City of issuance of a Mechanical Permit, <br /> 3arees to do all work in strict accordance with the ordinances of the City and <br /> t:�e regulations of the Minnesota State Building Code, and certifies that all <br /> s`Yatements made on this applicatian are compiete, rru� anu c�rr�c:�. <br /> , <br /> , — <br />�Fp licant' s Signature: �_ Date: '-5 � ��C7� <br />