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' `Aua-27-2001 02:16pm From-CITY OF ORONO +9522494616 T-69T P.003/003 F-670 <br /> , � �IREPLACES <br /> Gas factory fireplace <br /> Wood burning factory fireptac� with flne <br /> Wood Stove <br /> 'OV'ood stove with flue . <br /> Brand Name Modei No. <br /> VENTILATION. . <br /> No. � � � Kitchen Exbaust _ ducted recirculatin,g cfin <br /> No. � Bath�xhaust (m.ust be ducted outside) cfm <br /> No. � Otlier �r�s: Loca�ian�c � cfru <br /> FUEL STQ�tAG�E (MUST BE APPROVF� BY FIl2�MARSHAI,) <br /> Tnsta�lation " X �Remo�al . . <br /> _� F1�el oil: �� gallons �. � u�iderground �inside X outside <br /> � r P Gas: __ galions � <br /> other � �Qe�(�-or�� o,,, Gas openi.n� <br /> PERMIT FEE CAY,CUi,ATION , 9-I�-0 I � �V <br /> 1. 1.25% of Contract Pric�* or Mi�timu�n Fee �$35.00) � .��,' /,� � � <br /> � �?.,30� x .Q125 $ �$ �� <br /> " • . (con�ract price) <br /> 2. State Surchar�e. *�` Add the State Build.ing Code Divisian c�p ' 1 � <br /> Surchar�e to each pe�mit. - � 2� -3�G � x .QOOS $ �' I I � ' <br /> or $.50, whichever is greater {contract pric:e) , /.� <br /> � � ��J <br /> �� <br /> 3. �osta�e and H�ndling (Only mail-in applications) ' �$ � 1.50,,,_; <br /> 4. TOTAL PF.RiVIIT FEE (Add lines a-3 abc�ve) �$ 75 � <br /> , ` ^ ���, <br /> * C�NTItACT�'RIC�or JOB C�ST means the actual or estimated dollar ainount charged for thc - <br /> work including masereals,!abor,p:of.t,aad o�ier�ed cesLs. It'ss the a�aunt to be cbarg�d�o the customer <br /> for tbe work done. If any materlal,ec�tipment, labor,or i�stallaLipn are ftu'�ished by the owner,Ueua�lt or <br /> auy other party the reasonablc market value oi suCh items must be added to the e�titnated Cost or contract <br /> price_for permit fee purposes. In the event dia[tl�ere is a dispute on the apipunt of the job cost,the City may <br /> request the submissiou of a signed copy of the actual coatraeT. � <br /> '"* The STATfi SC„1'�tCHA,RGE is.0405 oPthe contract price ander$1,Opp,OQO or $.SO-whichever is gteater. <br /> � For valuauons over$1�000,000 call the Deparcment 4f Iuspectional Services for the price. <br /> The u�dersigned hereby ap�lies to the City fpr issuance of a Mechanical Pemait, agrees to do alI <br /> work in strict accordanee with the ordinances of the City az� the regulations of the Miranesota <br /> State Buildin� Code, and certifies that all statemencs made on this application are camplete, true . <br /> and correct. <br /> Applicant's Signature; _ (J�/ . - 17ate� �- /�-o� <br /> Apgroved By: _ Date: <br />