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y FROM : BARNES PLBG F�HOr•JE t•I0. : ���� 1�=�E��3 r�_ir,. t=15 ��NL� 1«:5�f�f'1 F�4
<br /> �:11 'Y UF UftUNU � 6'I��49461h Ut�;C��'� �uG 1'1 :�� ',�' :�:�5.!US P�G;�54
<br /> �����.� ��
<br /> _�_ Gas fac:tory fir��lacr
<br /> � -. Woad burning factory t:�r�;pl��:e witz� flu�
<br /> Wflod St�ve
<br /> + W'�Qd stove witls tlue
<br /> 8randName Mode.i Nc�
<br /> YEI�'�LATIQN
<br /> No. _^__ Kitchefl Ex�ia�ust ductcd reeircutacing � . ...,,M ctrn
<br /> No, � $a,�h E�ciiaust �must be ductesi outsi�e) .� cf�xa
<br /> No. Other �ans: I��ctltions cfln
<br /> �'iJE�.�.'�Q:RAGE {1�1t3ST BE AYP�tC)VE�3 b'Y ��IR.E �iP.RS�iAL.)
<br /> Installa[ion Removal
<br /> �� Fuel oi1: -y� gallons .�� untiergrouild ___ insidr __ outsidz
<br /> �„�_.,�,�, I�P Cas: _ galians
<br /> _�_ dth�r ,��..__.�.. W.�.,,T.� ----- Uas opening
<br /> v T �'�� f�,s���c�,TLATTON
<br /> 1, 1.w5�'� af�c�ntract, Price'" or ��,���i��'ee ($��.Oi�)
<br /> ���a oa � t .�1?� � ..._._.��`.,�_,_._..._._
<br /> (cpntraCt grEce}
<br /> �. ;St,ate._�urc,�r��, ** Add the 5tate ��,ii1�iF1� Code ��ivisic�n
<br /> Surchar�� to �ach perm'st. ,�j c7 '~ x .4005 � .-- �► 50 ____. .
<br /> �..�.,..�..,�.�.,....._,._ ._.._
<br /> or �.50, whichev�r is gz'eat�x ((;pc1LC�CC �CiC�3
<br /> 3, �'o�t��c an� dlins� (Only mail-in �p�li4ationsj ,� �.,�U
<br /> �. �ror�►r� P��iT FE� (Add lin�s �-� ��oYE� � __��-�U.
<br /> * CcJNT�.ACT F'1�IC�,or.3p�CpST m�ans the actual or estiu��ted doil�z �m����i�c��argcd fo�° the p�rmie�rd
<br /> work inCluding materiuts, l�b�r,groflt, and orher fixed e�sts. It is the airqunt to�c charg�d �o chc custor.�er
<br /> for the worSc dc�nc. It'any m.akerial, equipme�nt, lab�r, e�r ina«llacian are furnis;ze�i hy° th� nwner, te���nt ��r
<br /> any othar party ft�e rzasunable market va3ue of�uc•h it.ems musz DC� 3(jLjLCj SO C�12 zsrisxiazed COiC �r cnntr�,�_l
<br /> pri�e �as permit fev purpose�. 1n th�eve�nt that there is a d�,spute on thc: 3Tno��nc oi'ah�juh �nsi, chr. Ciry �Y�r,y
<br /> raqucac thc submissivn of a sigT�ed cupy oP the actual con�racE.
<br /> ** ThG STAT�SURCb{.4RGE is .00C15 of the contract grice un�cr $!,�rki3OUQ or `�.5t� - whichever is Krc3cc;r.
<br /> i�Qr val�1a;l�na ovcr �1,()00,oi)o call t�ia Uapartm�t�.c oi in�pec�iw?nz1 Scrvi���, Fc�r chr pri�c.
<br /> �I'tie uri�.ersigned h�rtby a�pplies ro ch� Cicy far issuanc� of a M�c:��anical Pet-rn.ic, hgi'Ze5 tC� c��: ull
<br /> work in strict accc�rdance with the vrt�inanc�s of ihe City and �h� regulatior�s nf the Minn��:ota
<br /> Scat� Building Cad�, an�i ��i�tttt�5 [haC �11 SC�k�rz�4nts ma�� c�i� t}�is �p�i2C21t30i1 at'Z COl2:p?et�, cn�c.
<br /> a�d correcc.
<br /> f�tpp�icat�t`sSi�t�atu �; �_,�_.�,�,. Uate: ,�[(�(��-
<br /> � -�✓
<br /> Approv�d By: _� .�_..�...,__......�_...._ �........___—_- ----- ��t�.: _�_.-----�---- --
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