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2-04-1998 3:09PM FROM FIRESIDE CORNER 612 633 888d P. 3 <br /> �. <br /> � ' <br /> . �.-� • <br /> � <br /> � WOOD BURNING EOU P�IPTTI�NT <br /> � Wood atove with fluc <br /> Wood combination or add-on <br /> Facwry fireplaoe w�th flue <br /> xxx Faccory Fireplace (s) Froestanding Masonry <br /> Wood Stove (s) Franlclin, other <br /> $�]v� HEAT AT GLO MOd�INO. 6000DVTFL NAT GAS <br /> Mfgr's Mia., Clearaaces, side , reaz , min. flue dia. <br /> T� <br /> vErrru,�TiaN <br /> � �No. Kitchen Exhaust dt�cted recirculating cfm . <br /> No. Bath Exhaust (rausi be duc�ed outcide) cfrn <br /> No. �ther Faas: Locatioas cfm <br /> • To�al <br /> F3II�, STORAGE (MUST BE APPROVED BY FlRE MARSHAL) <br /> Installatioa Reanoval ' <br /> Puel oil: gallans undergto�d inside outside <br /> LP Gas: gallor�s <br /> Other Gas o�ening <br /> P�';YtMIT F'EE CALCULATION <br /> � . . 1. 1.25� of Conaact_Price* or Miioimntn Fee_(�35.04) <br /> fjuaa� x .o12s $ ��.cx� . <br /> (c,ontract pr;ce) <br /> 2. State Surchazse. ** Add tha Statz Building Code Divisi�on <br /> Surchargs to each perntit. x .0005 $ . � <br /> (ooncract price) <br /> or $,50, whichever is greater <br /> 3. Postage and HandlinQ (Only maii-in appl�atioas) $ �r5� <br /> 4. TOTAL PERNIIT FEE (Add lines 1-3 above) $ ,35'-SS <br /> � <br /> s�� � * CONTRACT PRIC,E ot JOB COS7 maans the actusl or estimatod doilet amouat diarged for tt�e permittod <br /> c: woz)c includmg mata�ials, labor, profit, and other fuced oosts. It is t� amomu to be Ch�tged to the <br /> + customer for t�e wock don�e. If>my ms�eriai.eq�iipmont,labor�or iaatallaci�are funnished by the o�vner. <br /> � teaant or aay otltpr paurty tbe re�abk�rket valve of�icems mnst be added w d►e esrimicod cw�c <br /> "'�� or oaatrsci price ier permit fee purposes. Ia tbe evtat dut tbae is a disp�to oa the amo�nt of the job cosc, <br /> .. <br /> � the CitY maJ► lequ�sC tlu submissioa of a si�co�y of tb�e�ctual camtract. <br /> . i� . . <br /> :�- � ** Th,e STATE SURCHARGE is .0005 of the oo�mtra� price un,� 51,000.000 or 5.50 - w�►ea is <br /> �f greater. For valnaria�s ovea S1.000�000 catl tha Department of Iaspaxio�al Se�vioes for tbe prece. <br /> , <br /> The u�ers�Cd hercby applies to the City for issuance of a Mochaaicat Permit. agrees to do <br /> all work ia stricc aRxard:an�e with the ordinances of the City and die reg�iladons of che Min�sota <br /> State Bnilding Code, a�d certifies tt�at all s�made on this application az�e complete, true <br /> and conect, <br /> Appucant's Si�at�u+c: Date• <br /> Approved By, � Date: <br />