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. <br />�+` *WOOD BIIRNING _EQUIPMBNT $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 built-in <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. Ritchen Exhaust ducted recirculating cfm <br /> No. Bath Exhaust (must be ducted outside) cfm <br /> No. Other Fans: Locations cfm <br /> Total <br /> ***********************�*******************************************************s <br /> FIJEL _STORAGE (must be approved by fire marshal) <br /> $15. 00 Permanent/Temporary <br />� Fuel oil, gallons underground inside outside <br /> LP Gas, gallons <br /> Other Gas opening <br /> ******************************************************************************** <br /> GAS LINB INSPBCTION <br /> High/Low Pressure $15.00 <br /> *******************�************************************************************ <br /> PffitHIT FEB CALCDLATION <br /> 1. Total of above Installations or Minimum .Fee_ _(.$30..00) $; 3/7,�,D C_) <br /> 2. State Surcharge. Add the State Building Code Division <br /> Surcharge to each permit $ . 50 <br /> 3. Postaqe and Handling on aII mailed-in applications, $ 1.50 <br /> 4. TOTAL PERMIT FEE add Iines 1-3 above $�,:�� u ci <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 /> statements made on this application are complete, true and correct. <br /> Applicant' s Signature: -tt:c:,� Date: �% /�� - >� �_ <br />'�`w _ � <br /> I <br />� <br /> w <br /> �: <br /> � � <br /> � <br /> ' t: <br /> x <br /> � � <br />. . 4 <br />