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05�19i95 09:13 � �i�CITY OF ORONO 612-473-7357 �03 <br /> w n s � rrr <br /> Wooa stove with flue <br /> waod c�pab;nation or add-on <br /> Factory fueplace with flue � <br /> Facwry Fircptacc (s)� Preestanding Maso�tuy <br /> � Wood Stove (s) Franklin, other <br /> Brand Namc Model No. <br /> Iv��gr's Min., Clearanc�s, side�. rear�_, min. flue dia. _ - <br /> Tfltai <br /> � YON <br /> No. Kit�hen EXhaust ducted recirculating�� c�m <br /> No. � Bath Exhaust (mu�t bc ducted outside) cfm <br /> No. Other Fans; Loc�cians �� !. <br /> FilEL STdRA(� {i►�UST 1�E APPR�VF.0 DY F�RE MARSHAI) <br /> � Installation Removal <br /> Fuel oi1: galions underground inside _ oucside <br /> LP Gas: � gaIlons Gas opening <br /> Qiher — <br /> IT < A��C 01V <br /> 1. I.ZS`,� of CQntt�i P_ric�* Qr Minit Fec •00 <br /> ` �� ,�- <br /> ' x .p125 $ � / ,�' '�' <br /> — .�� , ,; cv <br /> _�t�(, �, <br /> (COnvact price) <br /> 2. te rch *"` Add the S�,ate Building Code Divxsion <br /> -, -; � x .00dS � �� ��� ', <br /> Surcharge to each permit. �'��'� � � ` <br /> {coutr�t price} <br /> ar $.50, whichever is greRter � �_�� <br /> 3. �osta�e and Han l�'�n8 (On1Y mail-in applicationsj � ��' . � /' <br /> 4. TOTAL PE�tMIT FSE {Add 1i�s 1-3 ahove) - <br /> +` CONIRACT PRICfi oC JpB COST means the actuaE�r eatimated dallar amatiwt charged for the perrnittod <br /> work it�elnding materials, labor. proft. and oiher lfaod costs. It ia tho uma�mc to be charged to the <br /> customer for the work do�. 1�any mattriaE, equigment�labor,ar inctaltatian are fiunis5ed by the owner, <br /> tenant or any othcr partY the reasonabie marka �alue of sut�iteuis must be added to the estimated cott <br /> or�au�ct p��e fot perunit fee pwposes. In�he event that there 9s a dispute on We amounc of tbc jab eost, <br /> the Cfry may reqat4t t�e auMniasion af a signvd copy of ctae actusi concract. <br /> �* 7'he S'fATE SURCHt�tdE is .0003 of Wo cantraee pricx uncier 51,000,000 or E-SQ - whichever is <br /> gCCatCr. �OT valu8ti0As bvcr�1�OW,000 csilt the Departn►e»t of Ioapectianul Secvices for the priGe. <br /> The undtrsigneci herebY a�plies to tt�e Cicy for issuancc of a Mechanical Per,mit, agrees tv do <br /> all work in sttiet aceardance with the ordinanu:�of tlye City ancl we regutarons of the Miu�sc�ta <br /> State Bailding Code, ��1d cert►�e5 that all Statements rnade on this application are complete, hue <br /> and correct. � � � <br /> � `� r��' <br /> Applicant'sSigi�ature' � �,� �. , Date� �-� <br /> Approved By: Date; <br />