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riTY OF ORONO ig 6124730510 01/03/97 09:065 :05/05 NO:695 <br /> _ W(4 $cove with flue. <br /> Wood.combination or add-oto <br /> Factory rimplace with flue <br /> Factory Fireplace (s) ._ Freestanding _ Masonry <br /> wow Stove (s) � Franklin, other _ <br /> Brand Ivarn� _ _ Mcxlel No. <br /> Mfgr`s Min.,C."learattces, side , tear min. Me Iiia. �_- <br /> YEN <br /> No, .--- <br /> No, ._ Kitchen Exhaust ducted. recirculating M c1m <br /> No. _ 'Bath Exhaust (must be ducted outside) <br /> No ��. Other Fans: Locations <br /> EM_aQ ► "E. (MUST RE' APPROVED BY FIR13 MARSHAL) <br /> InstallationRemoval <br /> Fuel oil_�__..__. gallons underground inside outside <br /> __... l..,P.Gall: _ gallons <br /> ------ Other _.. -- _ ,.._.,_ Gas opening <br /> �$1H T FrEE CALC��Q�V <br /> 1.25% of Coojgtom"r_&t* or MiVft.ug1:.Fee M35.491 <br /> x .0125 �_�d '7 0o Z <br /> (contract price) <br /> 2. State urcharee, ** Add the State Build]' Code Division <br /> Sura hargc to.each permit. —T-IP/7, _.:)_ x .0005 $ 4,.3 / y 3 <br /> or $,50.,. whichever is greater 4%intract price) <br /> 3. 1 td .ice (.)m <br /> is ( ail-in applicat:iot�fi) <br /> A,. TOTAL. PERMIT rE E (A-dd lines 1-3 alcove) $ � / j� I 134-7 <br /> * CONTRACT PRICE or JOB COST means the actual orast;mated dollar amount charged for the permitted <br /> work. including materials, labor, profit, and other fixed casts. It is the juiwunt to be charged to the <br /> customr~r rnr the work dope. ifanymaterial, tniripment, labor,or installatior are furnished by the owner, <br /> tenant nr arty other party the reasorrhble market value of such items must be added to the catimaw, cost <br /> or contract.price for peruuit fee purposes, .In the event that there is a dispute on the amount of the job cost, <br /> tf+e City may request the submission of a signed r"y or the .roast cuniract. <br /> The ST'A,rn. .51LtXCHARt43 is .0005 of the contract prick; under- $1,t)t)Q,tlUn ar x.S(I whichever is <br /> grealr.r, l'or valuatiortx over $1,000,M0 call the Department of Inspectional Sorviwg tier the price. <br /> TU undersigned :hereby ttppl i,;.i to the City for issuamce of a Mechanical Permit, agrees to do <br /> all work in striLt acctirr•lant a with the ordinances of the City and the regulations of the Mimesota <br /> State;Building Code, and certifies that all statements made on this application'are complete, true <br /> and correct. <br /> Applirattt`sS.ignatur : > <br /> -Dote: <br /> � ._ <br /> Apptoved By: T om __ — ._... _._ nate: _t <br />