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CiTY� OF ORONO � 6124730510 07/16/9b 13:46 � :02/02 N0:539 <br /> �'.�.�.�?.�?���lY�� 11I'�EN�, <br /> Wuocl stov� with flue <br /> ` W��uc! c'cxnhination or add-on <br /> ...._..._ <br /> .._._ ._. }"H4tctiry i�ireplHce with fluc <br /> �_� l�ac:tc�ry I�iE�e}�l,�cc; {s) _.�.w..� Freestanding � Masonry <br /> W�csd St�vc (�} Franklin, other <br /> F3rsir�cf Numc; W Model Nc�.�� — — <br /> M f�r'.� Min., Cl�:aran�es, sicle _____, rcar —..., -min. flue dia. _�,__ � <br /> Y�N��'�L���.�Y <br /> N�. _ Kitcben L:xhaust _ _ ducted _ _ recirculating efm <br /> [��>, _ ,.3 � �3aEh �xhaust (znust t�e duct�d outside) .�U cfin e�. <br /> Nc�. (]il�er l�ans: I,�cations � cfm <br /> �!:SJ�;�,.�'��l�A�(.�.� (MUS`I' �it: AI'P�cOVED BY FIRE MARSF�A1.,) <br /> 1n5I.►11<<1ic�n Removal <br /> --l-- ., _-_ T�u�l �,il; . , ,_ �;allons __w_ under�rc�und ` insidc _ oul6ide <br /> ---- L(' C;as: _.�..._. F�allc�ns <br /> Otltwr ._ ----------- - ----------_._._—_._ ______. Gds openin$ <br /> �.�.�.���. � ; ,,.s.���.�.������n <br /> 1. i .25�� c�1' .c► • �'r�* ��r ��ttimu[r� k~�c (�3�,�141 <br /> _____—_��3C�, ____ x .Q 125 $ _ _7�?.�-�' <br /> (contract price} T <br /> 2, 4�,a ��}irchar��;, �`* Add thc Statc Auilding Codc Division <br /> Siirchr�rge t� es►c;h nermit. _ 5�3�. __ x .00US $ � :�. rl � <br /> c�r $.5(1, whichever is �reater (c�ntract price} ` <br /> 3 I'i�s�.,'�c_1��la.i c�l�P�; ((�nly rnail-in applicati�ns} $ 1.50 <br /> 4. 7'()`('n1. f'f?RMl'1' l�i��: (Add ]ines 1-3 ahc�vc) $ __.�___.���_3c'-_....__ <br /> * ('()N'1'RA('T Pltlrli��r Jt�B('OS"I'mca��s the a�tuai ar oxtimxl�d cit�llar aincwn� cltargcd lor Ihe pcnt�iticd <br /> wc�rk incl+�ding n�atersals, laUor, profit, And other fixed casts. It is the amount to be cl�arged tu the <br /> CIISf0IT1CT �(11"�IlC wc,rk dnnc. tf any material, e.c�ufpment, 1st1��Yr, c►r installatian arc iurniah�d by the e�wner, <br /> t��n;3nt nr :uiy uti;cr party thc reasoizal�le maricct value uf sucti iteitis must be �dded tu tl�c esli�nated c�st <br /> i�r coutrsict price G�r pi�ri�iii (ee�inp�scs. in thc event ti�at Ihe:rr. is a disputc �n Alc:�smount of tlze job cost, <br /> Aic City m��y rcyuccl U�c sabmirvi�m of a signcd co�y of 1hc actual cot�tr;ict. <br /> *'" Cbe '�'fA'i'I; SL'RC�}IAit{;E is .0{H15 of the cohtract price under $1,00O,OOU or $.50 - whicheve� is <br /> g�r�iler. (�ur v;ilus►�ic+ns over $l,�t}O.t�00 call the D�°panmcnt c�f Inspecticmal Servic;es tor the price. <br /> (l'lie uruicrsi���cci hcrc�hy a;��li�s tc► thc Csty tc�r issuance af a Mcchanical ]'ermit, asrees to da <br /> ai} W��rk i» strict acr«�'d�liice wilh the c�rdinanc:es uf the �'ity and th� re�ulati�ms of the Minnesata <br /> �ts�1c 13�ii{cli�y�=. ('�,cl�, �mcl ccrrtitic� that all �tatcmerns madc an thi� ap�licxtiun �re c��m��lete. ts�u� <br /> And cc�r»ct. <br /> �►p�lic:�nt'sSikriature� -__=•s�c�� _W �, .�, -----��_...,�. ���_. Uate: �7-/�.� <br /> —� � � <br /> Apprt��vcd f3y: ----- -----__ _._ �.�� �____.,_._..._._._..._._____ Date: _�_L.�—°`._L�...�ip <br />