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<br />�e' *WOOD BURNING _E�OIPMENT $15.00 each unit ��
<br />�,-,' Wood stove with f lue '��
<br /> �' Wood combination or add-on unit `
<br />`��: Factory fireplace with flue
<br /> � � �:�
<br /> a Factor Fireplace (s) freestanding . . . . . built-in ����
<br /> Wood Stove (s ) franklin, other ��
<br /> . .. ._ . .. _ . .. . _. .. .. . __ �;
<br /> Brand Name Mode I No. �'
<br /> . ._.. .. . .. .. . .. ._ . .. . .. ._ _ .. . z:
<br /> Mfgr's Min. , Clearances, side , rear , min. flue dia. _ ;�
<br /> Total '��
<br /> ************************************************************�******************
<br /> VENTII�ATION $15.00 each project
<br />�: No. ! Kitchen Exhaust ducted recirculating cfm
<br /> �
<br /> `; No. _� Bath Exhaust (must be ducted outside) cfm �
<br /> �; No. Other Fans: Locations cfm ��
<br /> `' Total �-�
<br /> � ******************************************************************************* �
<br /> FDEI.. _STORAGE (must be approved by fire marshal) ,�
<br /> �fl-�=�� �Permanent/Temporary �
<br /> Fuel oil, gallons underground inside outside �.; �r ��
<br /> LP Gas, gallons �"�
<br /> E
<br /> Other Gas opening �;
<br /> ******************************************************************************* ��
<br /> ' GAS LIN$ INSPECTION '�
<br /> ` High/Low Pressure $15. 00 ;�
<br /> � ***********************************************************�**************** �
<br /> `�' PERMIT FEE CALCDLATION {_�
<br /> .�
<br /> :t; 1. Total of above Installations or Minimum _Fee__(..$30..00) $ ;�r
<br /> ° 2 . State Surcharge. Add the State Building Code Division ���
<br /> Surcharge to each permit $ .50 ����
<br /> r.
<br /> 3 . Postage and Handlinc� on all mailed-in applications, $ _ 1.50 ��
<br /> 4. TOTAL PERMIT FEE add Iines 1-3 above $.
<br /> .::`�
<br /> �
<br /> The undersigned hereby applies to the City of issuance of a Mechanical Permit i;�
<br /> agrees to do al I work in strict accordance with the ordinances of the City anc
<br /> the regulations of the Minnesota State Building Code, and certifies that a1=
<br />�'mxstatements made on this application are complete, true and correct. `
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<br /> Applicant's Signature: �,�-_�% ,�e Date: ���''--� w°��
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