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'����-k f <br /> :� ��_ <br /> .. .. . �.. g. �� A � t ' <br /> *WOOD BIIRNING EQIIIPMENT $15.00 each unit g <br /> s <br /> Wood stove with flue ������ f �� <br /> Wopd combination or add-on unit '��"� � <br /> Factory fireFlace with flue <br /> �. �� �: �,.r <br /> Factor Fireplace (s) freestanding ��_ Masonry �'�`"� <br /> Wood Stove (s ) franklin, other � <br /> BrandName Model No. '�;: <br /> Mfgr' s Min. , Cleararaces, side , rear , min. flue dia. � <br /> Total " <br /> *******************************************************************************x �� <br /> 3 VENTILATION $15.00 each project � <br /> No. Kitchen Exhaust ducted recirculating cfm �`� �F�� 1 <br /> 1 L_._ .� �,.,....� �..__ a,,��to,a �. t-�; �� cfm ���, �`;� �" . <br /> 1V0. t�tiL.11 E'1L1iQLii�. \•:•uo.. uC 1___C�`. <br /> No. Other Fans: Locations cfm A"� <br /> Total <br /> ****************************************************************�*************** <br /> FIIEL STORAGE (must be approved by fire marshal) <br /> ' $30. 00 Permanent/Temporary �,Y,:,s�,,� , ,� <br /> Fuel oil, gallons underground inside outside ,, , <br /> LP Gas, gallons <br /> Other Gas opening J <br /> ******************************************************************************** ; <br /> GAS LINE INSPECTION � <br /> � High/Low Pressure $15.00 µ� <br /> ******************************************************************************** <br /> ,-� <br /> � <br /> PERMIT FEE CALCIILATION � <br /> 1. Total of above Installations or Mini.mum Fee ($30.00) $ �30 �=� <br /> 2. State Surcharge. Add the State Building Code Division nxa <br /> Surcharge to each permit $ .50 �� <br /> 3. Postaqe and Handling on all mailed-in applications, $ 1. 50 ��"� <br /> 4. TOTAL PERMIT FEE add lines 1-3 above $ ,�,,�. p� <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 cert.ifies that all �� <br /> , ..�,�• � 4.,,,, z�M���r ?,-A r-nm�1 Pte, true and correct. � �. <br /> s�azerienLs 1liG��E or. �.�,3.� rr� � <br /> � � <br /> Applicant' s Signature: �G�� ���� Date: Y a•� / � <br /> � <br /> ���'"S`�.T,i }�� x�m ���,. 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