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�.�v-29 ,20�1 12:02pm From-CITY OF ORONO +9522494616 T-259 P.003/005 F-215 <br /> FIR�pY.ACES � � . <br /> Gas fact�ory fireglace � <br /> 'VVood burning factory fireplac� with flue <br /> Wood Stave <br /> Wood stove with flue , . . <br /> Brand Naz�e � Model No. � <br /> VENTILATION � . . � - . . � � . . . <br /> No. � � � Kitchen�xhaust ducted � recireulating cfm <br /> �No. � Bath Exhaust (must be ducted outside) � �� <br /> No. Other Fans: Locatian�c ' � � � , � ��� <br /> �'Y7EL STQRAGE� (MUST•BE APPROVET� BY ��MARSi�AL) . <br /> �Installation -� fiemoval � � • � � � <br /> Fuel oil: .gallons �^ underground inside outside <br /> � LP Gas: , gallons , . <br /> , >.Other . . Cas operung . <br /> PERMIT �"EE CALCULATION � � � <br /> 1. 1.25% of Contract Price* or ini m Fee 35.00 . <br /> «. <br /> . `/` _ x .O i2S $ '-' . _ __-_ <br /> } / G / <br /> I- e..._ <br /> � � �.`�....�_,`\ __7-._..> • <br /> ' ' (co,itract price) <br /> 2. tate Surchar e. ** Add the State Building Code Division . <br /> :�.> . <br /> . . Surcharge to each germit.. : �' c�,�_ �c, � x .0005 $ � � _ _ <br /> or $.SO, �vhichever is greater (conuacl price) . � . <br /> 3. Postage a. d�-Iandlin� (Only maii-ui applications) . . $ _.,� 1.50 <br /> 4. TOTAY,PERMIT FEE (Add lines 1-3 above) $ -�� 1 � -' '- <br /> * CONTRACT PRICE or]OB COST means the actual or estimated dollar amount chatged far the germitted <br /> work including materials,labor,profit,and ot�er fued costs. It is tbe amount to be chazged to the customer <br /> for�}1e work done. If any mater'eal, equipme.�it, labor, or iastal3adon are furnished by the owner,tenant or <br /> any other party ihc reasonable market value<�f snch items must be added to tlie estimated cast or contract <br /> _ price.for permit fee purposes. In the event that Ihere is a dispute on the au�ount of the job cost,the Ciry may <br /> � reques� che submission of a signed copy of th�:actuaI contract. , , <br /> '"* The STATE SURCHARGE is .00OS of the concract price under�1,Q00,000 or $.50-whichever is greater. <br /> For valua�ions over$1,000,000 call the Deparunent oP Iaspectional Services for che price. <br /> The undersigned hereby applies to the City f<�r issuance of a Mechanieal Permit, agrees to do all <br /> work in strict accordanee with the ordinaneFs of the City and the regulations of the Minnesota <br /> State F3uilding Code, and certi�es Lhat ali sta�emenis made on this application are complet�, true . <br /> and correct.� � � <br /> Applicant's Signature: �._.1}L�_���r �._. -�`�� � � -' _ Date: I l ��'�'i �1.�l — . <br /> Approved By: � ...�-�.'"-. � . -- Date:� � � /3�� � <br />