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<br />*WOOD BIIRNING EQIIIPMENT $15. 00 each unit a ���
<br /> Wood stove with f _ __. __--- . ' ' •� �
<br /> ------- _
<br /> Wood combination or add-on unit
<br /> �Factory fireFlace with flue
<br /> Factor Fireglace (s ) freestanding Masonry
<br /> Wood Stove (s ) • franklin, other
<br /> Brand Name ��,� X 1 l�� Mode 1 No. ,�� ���
<br /> Mfgr' s Min. , C earances, side , rear , min. lue dia. '�
<br /> Total
<br />********************************************************************************
<br /> VENTILATION $15 . 00 each project
<br /> t�o. Kitchen Exhaust ducted recirculating cfm
<br /> No. Bath Exhaust (must be ducted outside) cfm
<br />�To. Other Fans : Locations cfm
<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 />�z�x�TX��:**������t���t�*��-**�********************�r******************************
<br /> PBRMIT FEE CALCULATION
<br /> 1. Total of above Installations or Minimum Fee ($30.00 ) $ _�J c0
<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, $ . �l►,4
<br /> 4 . TOTAL PERMIT FEE add lines 1-3 above $ ?���-� _
<br /> I'he undersigned hereby applies to the City of issuance of a Mechanical Permit,
<br /> 3grees 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 this application are comglete, true and correct.
<br /> i - �
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<br /> Applicant' s Signature• �' � �/L 1�,� Date: c�' ��"�"� �
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