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<br />"f *WOOD BIIRNING EQIIIPMENT $15. 00 each unit
<br /> ,�:;
<br /> Wood stove with flue
<br />.�; Wood combination or add-on unit �•
<br />�, Factory fireplace with flue �,;�#
<br /> =` Factor Fireplace (s) freestanding Masonry - ".
<br />+�:� franklin, other �'
<br /> .�� Wood Stove (s )
<br />�' BrandName Model No.
<br />�=;:
<br />�� Mf r's Min. , Clearances, side , rear , min. flue dia.
<br />�, 9
<br /> �^, Total
<br />�ti *******************************************************************************
<br /> '�� VENTILATION $15. 00 each project
<br />�` .
<br />�,..; No. Ritchen Exhaust ducted recirculating cfm
<br /> No. Bath Exhaust (must be ducted outside) cfm
<br /> No. 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 />'R'� Other Gas opening
<br />� �; *******************************************************************************
<br /> *:
<br />� GAS LINE INSPECTION
<br /> g � $15. 00 �_
<br /> Hi h Low Pressure
<br /> *******************************************************************************
<br /> � PERMIT FEE CALCULATION
<br /> `� l . Total of above Installations or Minimum Fee ($30.00) $
<br /> fi= 2 . State Surcharge. Add the State Building Code Division a�
<br /> Surcharge to each permit $ . 50 5�?
<br />��' $ 1. 5 0 �
<br /> 3. Postaqe and Handling on all mailed-in applications,
<br /> x 4 . TOTAL PERMIT FEE add lines 1-3 above $
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<br /> - The undersigned hereby applies to the City of issuance of a Mechanical Permit
<br /> agrees to do aIl work in strict accordance with the ordinances of the City an
<br /> the regulations of the Minnesota State Building Code, and certifies that al
<br />�: statements made on this app lication are complete, true and correct.
<br />;�� /
<br /> Applicant' s Signature: �� � Date: %;�-3- � ( �'
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