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Dec-18-2001 04:13pn From-CITV OF ORONO +9522494616 T-318 P.002/OD2 F-530 <br /> F t�PItACES <br /> ' Gas factory fireplace <br /> Wood burning factory fireplac�: with flue <br /> 'DVood Scove <br /> � Wood stove with flue <br /> � Brand Name Mode1 No. <br /> 'VENTIL.ATION . � � � <br /> No. Kitchca Fxhaust ducted recircularin�g cfm <br /> �No. Bath Exhaust (must be ducted ovtside) cfin <br /> No. � Other Pans: Locatiom; ' ' cfm <br /> FUEL S7'ORAGE (MUST•BE A.PPROV��� BY FlRE N�►RSHAL) <br /> InstaAation Removal � <br /> F�cl oil: g�llons __ uadergraund inside � outside <br /> LP Gas: . gallons , <br /> .�_Other Gas opening <br /> PERMIT FE CALCULATION <br /> 1. 1.25°b of Cont�ct�ri�e* or� Fee 35.00 <br /> __,�.SC� < <�i... x .012s $ t �.� �!t� <br /> ` (contract price) <br /> 2. State Su�char�,ej, ** Add the State Building Code Jaivision -7 <br /> Surcharge to each permit. � x ,0005 $ � / � <br /> or$.50, whiehever is greater (conuacc prics) <br /> 3. Postag,e and T�anc�ling (Only mail-ir� applicadons) $ -YJB--' <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ �?� �� _ <br /> * CONTRAC'I'PRYCE or]OB COS7'meaas the actual or estimsced dollar amoum charged for the permitud <br /> work including macerials,labor,profn�aod other fued costs. It is the amount to be charged to tbe customer <br /> for ihe worlc done. If any muerial,equipmdu,labor,or instaUation ure furnished by the owner�tenaat or <br /> any pther parry the reasoaable matket value uf sucb iceaus antut be added w the estimaud cost or conuact <br /> prfce_for permit fee purposes. la We event rha�there is a d�cpute on the amomt of the job cost,the City may <br /> nquest the submission of a signed copy of th�:acttlal coatract. , <br /> '"" The STATE SURCHARGE is.0005 Of thE con�tect price under 51�00('1,000 or 5.50-whichever is greatcr. <br /> For valpacions over S1,000,000 catl the Department of Jaspectional Services for the priee. <br /> The undersigned hereby applies to the City fc►r issuance of a Mechanical Permit, agrees to do all <br /> work in strict accordance with [he ordinances of the City and the regulations of the Minncsota <br /> State Building Code/ cert�es t eme ade on ' application are complece, true . <br /> and correct. <br /> Appticant's Signa ,�L-----� Date: � � �'/ <br /> Approved By: Date: <br />