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U 1 r yr vKVPiv A rMit A l tvIN r vx AWLr"KA L rl!"U 1 Page 2 of 3 <br /> COOLING SYSTEMS <br /> Qty: <br /> Make: <br /> Model: <br /> Tons: <br /> H.Power <br /> PLACES <br /> Gas fireplace <br /> Wood b ing fireplace with flue <br /> Wood s <br /> Wye stove with e <br /> Brand Name Model No. <br /> TION <br /> ;No.'7 <br /> . 'tchen � duct recalculating=.cfin <br /> aunt(m eve dugo= de) cfin <br /> Other F •Locations cfin <br /> FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHAL) <br /> Instal nor <br /> Fuel oil: 11 underground inside outside <br /> LP Gas: Gas opening <br /> Oth <br /> PERMTr FEE CALC[JLATION(S) <br /> 3002 State Statute Yes This Section Applies ' <br /> 'The replacecn f a Residential fixture or appliagce--that meets all three of the following requirements: <br /> 1) Does not ire ny©dification to electrical or gas service. <br /> 2) a total 00.00 or less,excludin the cost of the fixture or appliance: <br /> and 3) amproved, installed or replace „the homeowner or licensed contractor. <br /> ' Skip next section; Cost of Permit $ 15.00 <br /> State Surcharge$ <br /> i Mail-In Fee $ <br /> If above does not app y, o ow guy a mes ow: <br /> 1. Contract Price* is.0125%of job with a Minimum Fee of($35.00) <br /> x.0125 $ _ <br /> (conte price) (minimum$35.0 — <br /> 2.State Surcharge. ** Add the State Building Code Divi aMnimum Fee of(S.50) <br /> a�� 161- <br /> x.0005 $ <br />