|
� �P - . � -
<br /> Gas factory fireplaee � � � �
<br /> � Wood btirn� factoxy fireplace with flue �
<br /> Wood.S[ovc � �
<br /> Wood stove with flue �
<br /> Brand Nam��P��J2f0�- 1V�ode�Na_ �� �j O�'/��
<br /> VENTY�,A,�4�T . . .
<br /> No. Kitchen Exhaust � ducted recirculat;uo�g cfim ' �
<br /> No. Bath Exbaast (must be ducted�ourside) ' � � 'cfim _ . .
<br /> No. Other Fans: Locations� � � . . . cfm
<br /> . �L STOR�iGE-(MUST�B�E APPROVE�:BY FIItE MARSI�AI..) .�� . � • . -�. �- _ . _ � . � .
<br /> • Installation°�. � � '� • Re�oval�� ' . �"�s-:'`�` :�- � - �•• � � � � � . �. .. � .� . - '
<br /> .� :��. '.• �,
<br /> -.;,,.. - . . . .
<br /> ' ' �k�e� oil_ _ ' . .gallons '..,--;'�• �underground ' -• � �iside��.--.•�;:. � ; outside
<br /> . .. ;�P.Gas: .gatlons � ;�,:�;- .�,;� � � ���_� .;�.:� :.:• .�=�;":r,; � � '
<br /> . ' .�Otlier'.. . . . . . '�;�:. '' _ � - ' � -C3a.s�9Pe���"° �
<br /> . . , . . . . . . _ .. . .��.�_ ��� .� . .
<br /> . . . e . . � , :,.:::� "�. � : '- ::' "r �:�.•.:..:: :, .
<br /> P�iR�I.��L�I. _� N. . ..- ::*:;,r.�y,¢Ff„?'.,.,(,�,;;�:±c,, • . • '. , :�,�.?::'.• •':. ': . . . ' . "'. .
<br /> : .' 1. 1.25°�6''of�o�tractPrice'�'or� �• `�'� � 5:04 ': ,�� ,:., ..,�;��-..�; •:.:�::. . . �,�.� ' �
<br /> . : •a•:��. • f�/^� _�,� y..MY:,�_r. i�:;: t/'�� . ' • `:,�. . .
<br /> . i. �•J.� M'.• .I • {'/1 / . '�1t��i i�r'�-T.^,-i�v....", •X .OlLir.7 , ;� , _ . '
<br /> ` ' .Y •'�• �•'I ' . . 1 �.V / /y►��/Y�j� `■ , ,� �.• ,..
<br /> �i �.f ;���� r � � '• �'. ��`�1j�I.����. •. r ��y� • ,' •,
<br /> � . � ' •, i• ,•, � ' r i. . . .. � �r'���•f -' .• � .��r _ _•��� ;~'.. .-•..• .
<br /> Add the S`I�t,e� � cid�e:Divisi�' =�°•;'`• •:� ` •• r.
<br /> ` ' ,' • • 2. �dtB'.Stl_��- '!`�` ��$'��.. .� ^ ", ,J': �,� �3,'• ,:. . •;: .. , ' .
<br /> � ' - • .,� i � , w N. :. . ',.:�.'v kT �';': ��� +i��;. r:�i.
<br /> • . . �;:.��j,,;�� .. .�r�-�Sfi.-4,-_g' �,'°'`'•��= Y � . �j� ..� � .
<br /> ,''�•"• ' ��"' e:" 6��� � � �� ,' J $" r,:;�'`-' ., .
<br /> �' . ���Giw"���:��+.rt�''�.:;2a, .,�,a�, a...�'�,��'�+`�� ;�� �.��! 3 .�� �'{' 'ti r="+'•
<br /> ' ` , - .�• .. ' y.•• 'y� r,� tir�= :- • • • �►r�� '•^+Y:•:: _ . . . 4.. - ' ••, ' • . . •
<br /> . . , . :�1��..70 �111C��.�.�}ya�.i h ^�ti\~ ,. .�;.;.�:_ : . .� \.y. `tiY+iu�.S;T+�ri'�•t��' '<, .. . .
<br /> • � � 'I: .5a"""'"'a C�.� �.y . •.�';.
<br /> . . . . :�, . , ",.a .�`^`+�„;t�:-� . . . t �,li• ' . ..�i '..� .
<br /> , •3�' •�� ' � • ' . ' �. ' , . . ' •
<br /> � 3. '. . �os�ge and Handiirig� -�(Only.mail ia applications) . .:,:r� :;t�$,;;=.: � :..:.�1�.50 _ . , -
<br /> � . 4: ,��OTAi:P�RNIlT�FEE � � (Add li�s.?l;3.�aliovc) �. . � . �:,._� ':����� :;:��� � �- . .
<br /> . ; :�:�:•,: .�. .: . � • : ., .•�.�.:.._;�. �. •. . . ;. . �• . � .:.�:. � . . .
<br /> . .•>lei�•_ . , . �... ;'?.i',,�:',. ? . ...n" . •r;`'Y.,-• , •,
<br /> , � .t.. � . .• �.:..�J •T.i ?'��-";� ' . . . .t i i
<br /> • • ' ' ' * ��CONT(tXC'�'p1tIGE O�?OB CO$T meaffi l�ue a�sl bi.�ma��011ffi'sm�lmC'r�arped fo r�petmittcd . . •
<br /> . �
<br /> • . ' � �.work�liidiagmaterials',;l�boc;.pro5t;�aad:��Sii�.�,�:1t is the amo�t�obe`cbargad;to'the"� . .: •
<br /> , . . -. .. :_for ihe��''rwrl�d�o�::..�if.any m�isl;�;78bo�t?�or;,'.i�st�llaha�at� �f�r�:tiy'thie`;owner;'ceosat or= ,•,'-.
<br /> � . : aay athei pany'the reasonable maalaet iislue°.��ach�iiema ulusi be added td`f�e'iestimaaed"cost:t�oo�tiact • . ,
<br /> • • pric�far permit fee purposes. Ia the e�veot t�at there is a dispnte on flu am;oimt of'tbe job eosc,t�e L�itY ma�' .
<br /> • request the submissien of a sign�ed copy of the a�aal�. � '. . . . • . : '
<br /> � The STATE SURCHARGE is .0005 of�e�price nnder$1,000,000 or 5.50=which�;wer is g't�r- •
<br /> .. . ;�•• , . �.•::r►••�•For-v�h�tio�over$1�000�000 C8���„�A[�O�aI]lS�CCtlOnsl . .SC��Yl„CC�,,S<�OT,;•►��C f3:'re,';..tqa�cw.���c>c�.�. •. . �, . •
<br /> • . i.s•i,�..•:.:. • ���• . , , .. , ' ,'x;;��.x�fi�,✓`:•��,7p.s7�'ti^�M.. � . � r4�y�J:`;".'�.':'�nY,..�'r,' , '•T' ' '
<br /> . - ''.►•��••��'The�undez's' �ig�ed•h�essecby aPPl.ies to the City.��or�ssuatiice°of a Mecha�icai.�'e.�it;�:s�yto•do,all., ..��;.....
<br /> h�,::
<br /> � aork in strict'accordance with the vrdimance's of the City and t�e regu�ations'�of'the•Mimaesota • '.
<br /> 5`tate Building Code, and certYfies that a11 statements made om this application are com�lete, txue
<br /> and cortect. .
<br /> Applicant's Signaoire: Date: � �' 8'P
<br /> Approved By: Aate:
<br /> C00� 1�'IddR5 5?I�Q'IIIIS 5tI�it19 L880C55C9L YV3 C��OT i0/LZ/Zt
<br />
|