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Nov-05-2001 10:24am From-CITY OF ORONO +852Z484610 T-122 P 003/003 F-92T <br /> �'�12EPLACES <br /> Gas factory fireplace ' � <br /> Wood burning factory fireplace with flue ' <br /> Wood Stove <br /> Wood stove with flue <br /> Brand Name Model No. <br /> 'VENTTLATTON � � <br /> No. Kitchen Exhaust _ ducted recirculating cfm <br /> Iv`o. Bath Exhaust (must be ducted outside) cfrn <br /> No. Other Fans: Location; cfm <br /> FLJEL STORAGE (MYTST BE APPROVEL� BY FIRE Mt�12SHAL) <br /> Lastallation Removal <br /> �el oil: gallons _., underground inside outside <br /> LP Gas: gallons <br /> .� Other Gas opening <br /> �'����I'�' �TE CA�,CULA.TION <br /> 1. 1.25% of Contract Price* or t�tinimurr�Fee 35.00 � <br /> �`l, a 3 , X .oi2s � _ J,� <br /> (coiitract price) <br /> 2. Scace Surcharee. ** Add the State Buildi � Code Division <br /> Surcharge to each permit. ���� `'t� x .0005 $ ��.� --� <br /> or $.50, whichever is greater (comract pricc) <br /> 3. Posta�e and Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (Add ]ines 1-3 above) $ � :�J��o� <br /> + CONTRACT PRICE or]OB COST means th�:actual or estimated dollat amouat charged for the permitted <br /> worl:including macerials, labor,profit, and oAur fuced coscs. It is the aawunt to be cha.rged to the customer <br /> for the work done. If any ma[erial, equipmei�t, lehor, or installation aze furnished by the owner, tenanc or <br /> any o[her party the reasonable mackec valuc of such items mus�be added Co thc escimated cost or contracc <br /> price,for permi[fee purposes. [n the event tha�.chere is a dispute on the amount of tht job cost, the Ciry may <br /> reques� [ne submission of a signc:d copy ot the ac[uai contract. <br /> *` The STATE SURCHARGE is .0005 oP the coi�cract price under$1,000,000 or 5.50 -whichever is greacer. <br /> For valuatio�s over 51,000,000 call the Depa,•�rnent of Inspectioaal Services for the price. <br /> The undersigned hereby applies to the City fo►• issuance of a Mechanical Perrnit, agrees to do all <br /> work in strict accordance wi[h the ordinances of che City and the regulations of the Minnesota <br /> State Building Code, and certifies that all stat�ements made on this application are complete, true <br /> and correct. <br /> Applicant's Signature: �, - Date; J J� <br /> Approved By: Date: <br />