Laserfiche WebLink
�2i02i93 11:15 THE CITY OF ORONO 612-473-7357 002 <br /> ` R . <br /> WOOD BURNiNG EOUIPMENT <br /> Wood stove with flue <br /> Wood combinatian or adcl-on <br /> _ Facta.ry �replace with flue <br /> Factory Firc�lacc (5) �ceestanding Masanry � <br /> Wood Stove (s} Franklin, other <br /> $rand Nan�e Model Na. <br /> Mfgr's Min., Clcaranccs, sid� , rear , min. �1ue dia. <br /> Tpta! <br /> VENTiLAT�ON <br /> IVo. Kitchcn Exhat�st ducted recircutating cfm <br /> No, �3at}a �xhaust (must be ducted dutside) cfn� <br /> No. Other Fans: Locatior�s cfm <br /> motal <br /> FUEL STORAGE (MUST BE APPROVED $Y �'IRE MARSHALj <br /> Installation Remavat <br /> Puel oil: gallons ____ undexgrou�nd inside outside <br /> _ _ LP C3as: galloiis <br /> Other Gas opcning <br /> � , <br /> �ER,MIT FEE CALC(JLATION ' �'�� <br /> �. 1.25% of Contract Price'" or Minimum Fee ($35A4) $ ; =�`�' <br /> 2. State Surcharge. ""� Add the State Building Cc>d� Division $ � <br /> Surcharge to each permit. <br /> 3. Posta�e and Handlin� (Only mail-in applications) $ �_� Sz; <br /> 4. TOTAL PERMIT PEE (Add lir�es X-3 abave} $ _��' j�` �— <br /> * CONTRACT PR[CE or JOB C05T means the actual ar estitnated doilar amount charged for ihC pern�tittCd <br /> work iucluc�iug uustCriula, lxtwr, prc�fil, xnd ��hcr fixr.d costs. Ii ix thc amount to be charged tv the <br /> �ustuuicr for ihC wurk dun�. If any matcrial, c:quipmcnt, labc�r, or installatic►n are furnished by the owner, <br /> tcnani c�r any o�her par�y thc rcasvnablc market valua o�such it.ems must be added to the estlmated cost <br /> or cantract prica for permit fee purposes. In the event d�at there 9s a dispute on the smnunc vf thc jvb cost, <br /> the City may re�uest the submission of a signcd copy of thc actual c�ntract. <br /> ** The STATE SURGHARGB is .Q005 of the contract prlce under �1,OOO,U00 or $.5� - whichevCr is <br /> greater. For valuations over $1,000,000 cal� the Depariment of]nspeccional Services for the price, <br /> The undersigned hereby a��Iies to the City for issuance of a Mechanical Permit, agrees to da <br /> all work in striet accordance with the ordinances of the City and the regulations of the Minnesota <br /> State Buildir�g Code, and certifies that all statements made on this application are cornplete, true <br /> and carrcct, <br /> . �,-�; <br /> Applicant's Signature: ���,�� �� �fi�f��l':� Date: � 'Z{��'� <br /> (�•�< �'`r.1'� <br />