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Nov-05-2001 10:24am From-CITY OF ORONO +8522484616 T-122 P 003/OD3 F-B2T <br /> �XREPLACES <br /> Gas factory fireplace <br /> 'V'Jood burning factory Freplace with flue <br /> Wood Stove <br /> Wood stove wich flue . <br /> Brand Name Model No, <br /> 'VENTTT,ATrON � � <br /> No. Kitchen Exhaust _ ducted recirculating - cfrn <br /> , No. Bath Exhaust (must be ducted outside) cfm <br /> No. Other Fans: Location:; cfrn <br /> �t1�L �'I'G�G�; (tviu�i i��, ArrKuv�i� i�'Y ritc� �rit�ij <br /> Iastallation Removal <br /> �el oil: gallons _„ underground inside outside <br /> LP Gas: gallons <br /> .- Other Gas opening <br /> P�RIl�IT � CA�,CULA.TION <br /> 1. 1.2S% of Contract Price* or Minim sn Fee ($3S_00) <br /> 7%��1, ���� x .oi2s � . � �7. �� S <br /> (coii[racc price) -- — <br /> 2. State Surcharee. ** Add the State Building Code Division <br /> Surcharge to each pernut. ��7 �7`l �i� x .0005 $ � �.�( <br /> Or $.50, whichever is greater (comract price) <br /> 3. Postage and Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ �)�� ,�;�-} <br /> + CONTRACT PRICE or JOB COST means th�:actual or estimated dollar amount charged for the permitted <br /> work including materials, labor,profi[, and ot)�er fiXed costs. It is the amouat to be charged to the custotner <br /> for the work done. If any material, equipmeta, la6or, or instellation are furnished by the owner, tenant or <br /> any o�her parry the reasonable marke[ value of such items must be added W the escunated cosc or conaacc <br /> p;ice,fo; �errr7it fee pu:po�es. in c;�c eveot t�a�,cuere is a diapuce un ti�c aaiowii vi u►e j�b wst, we Ciiy;i�ay <br /> requesc[he submission of a signed cooy of the actual contract. <br /> *� The STATE SURCHARGE is .0405 oP the coiitract price under$1,000,000 or �.50-whichever is greacer. <br /> For valuatiotLs over S1,000,000 call the Depa,��ment of Inspecuoaal Services for the price. <br /> The undersigned hereby applies to the City for issuance of a Mechanieal Permit, agrees to do all <br /> work in strict accordance wi[h the ordinances of the City and the regulations of the Minnesota <br /> State Building Code, and certi�es that all stat��ments made on this application are complete, tcue . <br /> and correct. <br /> , <br /> Applic2n['s Signacure: v� r ' S2�'�` \ - Date: � �� Jc3" <br /> ` �. <br /> Approved By: Date: <br />