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Ju1-18-2�00 11:36am From-CITY OF ORONO +9522494616 T-1�$ P O�Zl005 F-300 <br /> F E�c�s � �I� � <br /> Gas factory fireplace � <br /> Wood btir�iuig factory fireplace with flue <br /> Wood Stove <br /> Wood stove with flue � <br /> Brancl Name Mode1 No. <br /> VENTILATiON ' <br /> No. Kitchen Exhaust ducted recirculadng cfrn <br /> No. Bath Exhaust (musc be ducted outside} cfrn <br /> No. Other Fans: Locations cfm <br /> FLTEL STORAG� �MUST BE APPROVED BY FIRE MARS�AL) <br /> Insialtation Removal <br /> �uel oil: gallons underground inside ouuide <br /> L.P Gas: gallons <br /> Other � QP�S <br /> PERMYT E�CA�.CULATIQL�I <br /> 1. 1.255'a of Gont�act Price* or 1..1�inirnum�'ee (�35.08� <br /> x .ot2s � �l �. ��� <br /> (conuacc grice) <br /> 2. Stace ,�urcharge. ** Add the State BuildiAg Code Divisian <br /> Surcharge to eacb permit. x .00(�S $ • 5� <br /> or $.50, whichever is greaier (contract grice) ' <br /> 3. Pasta�e and H�n.dli� (Only mail-int applicauons) � $ i•�fl <br /> 4. TOTAL PERMIT PEE (Add tincs 1-3 above) $ '� `f.-J S _ <br /> * CONTRACT PRICE or 10B COST means the actual or estimated dollar amounc charged for the permitted <br /> work ine�uding materials,lflbor,profit,aud orher fixed eosu. It is the amouac to b�ebarged to the customer <br /> for the work doae. If any material.equiFment,labor,or installation ara furnished by the owzur,[enant or <br /> nuy other parry tht reasottsbie markst vnlue of such items musc be added to tbe es�ed cost or contract <br /> price for psrmit fee puiposes. In rhe eve�t that there is a dispute oa rhe a:aounc of che job cosc,t4e Ciry may <br /> request the s�bmission of a signsd capy of the actual conuact. <br /> *" The STATE SURCHARGE is.0005 of the comract price under S1,04b,00U or $.SQ-whichevet is greater. <br /> Por valuacions over SI,OQQ,O�b call the Degartment of Iospecuonal Services for the price. <br /> The undersigned hereby applies to the Cit� for issuance of a Mechanical Pernait, agrees ca do all <br /> work.in strict accordance with the ordinances of the City and the regalations of the Minnesota <br /> State Building Code, and certifies that all statemenu made oa this applicaiion are complete, tnie <br /> and correct. � <br /> Applicant'sSignaaue: � ,� Datc: �l`I�� - <br /> APproved By: � Date: <br /> , . <br /> ,� . .. <br /> ��I <br /> s �i'i <br />