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, <br /> *WOOD BDRNING EQIIIPI�NT $15.00 each unit <br /> Wood stove with flue <br /> Wood combination or add-on unit <br /> Factory fireFlace 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 : Locations cim <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 $15 � 00 <br />****�****x**x�x*�xxXn�xx�kxx�**kzk���kxX•k���x����x*�if:'.�*x�x�zzx**x****�********� <br /> P$RMIT FEE CALCIILATION <br /> 1. Total of above Installations or Minimum Fee ($30.00) $ =��' G- �% <br /> 2. State Surcharge. Add the State Building Code Division. <br /> Surcharge to each permit $ . 50 <br /> 3. Postaqe and Handling on alr mailed-in applications, $ 1.50 <br /> 4. TOTAL PERMIT FEE add lines 1-3 above $ - ,_y . f�---c= <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 thi�-�}pplication are complete, t�ue and correct. <br /> ,� ,,� a ,;;� -'`�' <br /> . <br /> �'d,,,-�"`,�;�; �};:� . `-- �:: °<:;�.�.' i <br /> � ;,.. , . <br /> AFp licant' s Signature Date: ���'= " �� `j / <br /> ��� , �_.. __..,. <br />