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*WOOD BURNING EQUIPMENT $15 . 00 each unit <br /> Wood stove with flue <br /> Wood combination or add-on unit <br /> Factory fireplace 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 /> VENTILATION $15 . 00 each project <br /> No. Kitchen Exhaust ducted recirculating cfm <br /> No. Bath Exhaust (must be ducted outside ) cfm <br /> No. Other Fans : Locations cfm <br /> Total. <br /> ******************************************************************************* <br /> FUEL STORAGE (must be approved by fire marshal. ) <br /> )� $30 . 00 Permanent/Temporary <br /> Fuel oil,,- '1 gallons underground __ inside outside <br /> LP Gas , gallons <br /> Other _ Gas opening <br /> **********************************x**�k**�**it*iris'!c*>ts4ic�cki•****1h**fir*******x******** <br /> GAS LINE INSPECTION <br /> High/Low Pressure $ 5 . 00 <br /> PERMIT FEE CALCU'LAT'ION <br /> 1 . Total of above Installations or Mirimu= "'ee ($30.00) $ <br /> 2 . State Surcharge. Add the State Building Code ivis On <br /> Surcharge to each permit $ . 50 <br /> 3 . Postage and Handling on all mail-ed <br /> applicatier�s , 1 . 50 <br /> 4 . TOTAL PERMIT FEE add lincs <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 an: <br /> the regulations of the Minnesota State Building Cede, and certifies that al <br /> statements made on this application are complete, true and correct. <br /> --,rDate: <br /> Applicant' s Signature: �� <br /> /O� OUB 5 �, vV� b I e v401 <br /> O <br /> \J <br />