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Ncv-28-2000 12:28pm From-CITY OF ORONC +9922484616 T-054 P.002/002 P-516 <br /> . , <br /> . - , ,, <br /> i FIR.EPL�S <br /> • Gas fact�fireplace � <br /> �� Woad burning.faccory freplace with flue <br /> vVood Stove ' <br /> � Wood stove with flue � � <br /> ' Brand Nariie � Mode�No. <br /> , � <br /> ��T��N , <br /> No. T�itchen Exhaust ducted -reeire�zlating cf7n <br /> No. Aath Fxhaust (must be ducted outside) c� � <br /> - No. Other Fans: Locacions ; --- cfm <br /> �I,�EY,�S'�nR.AGE (MUST BE APPROVEll BY FtRE MARS'HAr.) <br /> Installation Removal � <br /> ; . Fuel oil: _ ga]lons � wnderground � ___ inside outside � <br /> LP`Gas: gallons ' <br /> � Urher � _____,_� _ Gas.opening <br /> � <br /> pERMI�CALCULATI�I�' , 7 � <br /> um Fee L�;}�RQ� � ' --' �(, <br /> 1. �..25% of�Qnrracc Price* or inim � � <br /> __— � �� (:_;l� __ x�.O1'�� $ �.� � � <br /> (can�rac[price)� <br /> 2, Scate SurcharPe• *� Add th�Stace Building Code Divisian <br /> Surchar e to each rmis. v� x .00��'� $ : <br /> g Pe --�--1��-��--.-.-- <br /> � or $.�0, whichever is greater (conn�act price) � j i <br /> 3, e and�'��1li1,g (Q�ly mail-in apptications) $ a , -- - � <br /> 4. TOTAL P�RMTT �EE (Add tin�s 1-3 above} � $ � � / <br /> +�. CONTRACT PRICB or 30B CaST means ehe actual or estimAud dotlar aznount charged for tbe permined �� ` <br /> wozk iueluding materials,Iabor,p[o�iT,and other fixed cosis. It ts the azr.4ttt1[to be chuged to the custoirler � <br /> for[he work donc. If aay malerial,equipment, labor, or installaaon ar�fuspished by the oWner,r��t ar <br /> any ocher parry th�reasonable s�axkes value of such i�ems must be add^:d co clie eatitn�ted cost or conaact <br /> • price for permic fee purposes. ln che event that there is a dispu�e on.it:e z�tauYtc of th�job cost;the Ciry may . <br /> reques�che suD�ission of a signed copy of ihe actual coetsact. <br /> ** 1'he STAT�SUR�HARCr�is .0005 oEthe contsaCt prite tu�der$1,00(7,�00 or $.50-whichever is gseater. <br /> For valuations over S'.,�OO,OQO cal]the Departmenc of basptt�'sonal Sek^�ices Par the price. <br /> ThE undersigned hereby applies to th�Ciry for issuance of a Mechenical Permit, agrees to do all <br /> work in strict accordanc� �vith thc ordinances of the Ciry and the r�8ulatious of the Minnesoca <br /> State�uildin�Code, a ertifies chat atl statements mad�on this applicaaon.are camplete, true <br /> ;and correcc. , i � <br /> �� ,L <br /> Applicant's S�nac�re: __ Dace: . <br /> _ APPiovedBy: __ -.._----- ._.. Date: ' <br />