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<br /> *WOOD BIIRNING EQIIIPMENT $15. 00 each unit
<br /> Wood stove with flue
<br /> Wood combination or add-on unit
<br />_ Factory fire�lace with flue
<br /> Factor Fireplace (s) freestanding Masonry
<br />���`; Wood Stove (s ) franklin, other
<br /> BrandName Model No.
<br /> Mfgr' s Min. , Clearances, side , rear , min. flue dia.
<br />�= Total
<br />;� ' ********************************************************************************
<br />"a VENTILATION $15. 00 each project
<br />��;
<br />��;
<br />�� No. Kitchen Exhaust ducted recirculating cfm
<br /> r' No. Bath Exhaust (must be ducted outside) cfm
<br />��, No. � Other Fans: Locatic�i�� �fm
<br />�� Total
<br />�{.
<br />��-z ********************************************************************************
<br />�:.,
<br />�' FIIEL STORAGE (must be approved by fire marshal)
<br />�. ' $30. 00 Permanent/Temporary
<br />�'� "
<br /> Fuel oil, gallons underground inside outside �
<br />� LP Gas, gallons .�
<br />�t Other Gas opening �
<br />�:. ic****�t*ati�k*�t�c�F****ic�k*******it**�t�tic�t�t*�F********�Y*�k******�tic�k********�t******�Y***ir***�t �^:
<br />��
<br /> ��` GAS LINE INSPECTION
<br /> ,:'� High/Low Pressure $15 . 00
<br />�� : �*********************k*****f****,t�************�c**�r**�t**;��t*;�r����xxx*x*�**�c*�c�t** ,.
<br /> ':s
<br />�; PERMIT FEE CALCULATION ;�
<br /> '"�'= 1. Total of above Installations or Minimum Fee ($30.00 ) $ �Q.b� � �?�:�
<br />,�; 2 . State Surcharge. Add the State Building Code Division �^4°°.
<br /> �' Surcharge to each �ermit $ . 50 ��
<br /> '; 3 . Postage and Handling on all mailed-in applicatians, $ 1. 50 ��'
<br /> t 4. TOTAL PERMIT FEE add lines 1-3 abcve $ �;-�,�'j
<br />�F;
<br />,:;� .
<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 certifies that all ���
<br /> st=_+�:T+en�s *e��1P on this anplic�tion are complete, true and correct. �
<br /> �,
<br />'��' , _�� ::'
<br /> �: Applicant' s Signature: ci' C� Date: ����7. �
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