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CITY OF ORONO � 6122494616 OS/14/99 13:28 � :03/05 N0:334 <br /> r ' � <br /> ��� $'�1RNiN , F.(ITT�►M�i;N'i' �,/' � <br /> Wood stove with flue . <br /> Wood conzbination or add-on <br /> � Factory fireplace with flue <br /> � Faetary �ireplace (s) Freestanding Masonry <br /> WOod Stove (8) � F�rariklin, Other � .� <br /> Brand Name � � � Modd No. � . <br /> M�gr's M�n., Ciearanccs� side , rrar , min. flu� dia, <br /> �Ly.T AIL TI,ON � <br /> � No. �_ Kitch�n Exhaust ductcd recirculating � cftn <br /> , No. �_ Bath �xhaust {mu�st bc ducted autside) �� cfm <br /> No. _�„ Othcr Fans: Locations �a ,�-�rsn� s �� c�'m <br /> �i� STORAGE {1ViUST BE APPROVED BY �I� MARSHAL) <br /> Tnstallatfon Removal <br /> P�cl oil: gallons undez�grourzd insidc outside <br /> I..p Gas: gallons <br /> ,�„_, Other C3as opening <br /> �K����r.Ar.t�trr.aTrniv <br /> 1, 1.25:� of�onCtacr Pricc* ar 1���u�m F�� [�35.Q0) <br /> ��� �Sr� x .0�25 $ /� �.�� <br /> (coatract pdce) � <br /> ' 2. Statc Sureha.rQe. ** A,dd the State Buildiz�g Codc Division <br /> Surchargc to each petmit. �4 — x .p00S $ �• �� <br /> ar $.50, �uvtuch�vcr is greater (concract pricc) <br /> 3. ��g� and Handlin� (Only mail-in applicatians) $ _ , ��,�p <br /> 4. TOTpiL PERMiT FEE (Add lincs 1-3 above) $ / �O . � � <br /> '` CONTRACT PRTCE or J�B COS'T meaas the actual ar estimated dolliu amount cbargcd Por the permitted <br /> work including materials, labar, profit, uid ather fixed costs. It is the amounc co be charged to the <br /> custoiaor for the work done. If any mat�rtal, equi�menc, labor, or instaUacion are furnished by tha owner, <br /> tenant or any othcr party the reasonablc market v�lue of auch it�ms must be added to the cstimated cosc <br /> or coatract price for pormit fca purposes. In the event that there is a dispute an the amount of the job coat, <br /> the City may requcat the cubmi�sion of� s{gnod copy of tht actual �ontract. <br /> *• 'Y'he STAT'E SURCHARGE is .0005 of thc contract price undcr 51,000�000 or S,SO - whichevcr is <br /> grcater. For valuat'iqns over 51,000�000 eall the Department of Inspectional 5ervices for the price. <br /> The unflersigned hereby applies to the Ciry for issuance of a Mechanical Permit, ag�ees to do <br /> all work isi strict accordance with the ordinances of tt�e City and the regulations of the Mi.ru�esata <br /> State Huilding Code, and certifies tbat all statements tnade on this application are complete� true <br /> and correct. � <br /> Applicanc's Signature� _ � Date: <br /> �/�. <br /> ` � <br /> APprovcd By: Date: � <br /> C� �'- � " �� <br /> � <br />