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Rx Date/Time RPR-10-2001 (TUE) 0T :90 +9522494616 P, 003 <br /> Apr-10-2001 OT:42am From-CITY OF ORONO +9522494616 T-845 P.003/003 F-387 <br /> � � ; .. . <br /> • , ,, . . . . . <br /> , . , . . � � . � ' � . ' . . <br /> , �i ' ' , , . � . . _ , , <br /> , �', , FY�PLACF� � ,. . � , , . . , : , . . . <br /> � . , Gas.factory f ireplace . • . � , <br /> ,. �� , <br /> � � � , � Wood laurnin,g factory fireplace with flue ..: - ` - . . . . , <br /> . ' . Wood Stove ' . ' � , .. <br /> . •. ' - Wood.stove.with flue . � <br /> . I , '.. Hrand Name � ' IN1odelNo, , ' , � <br /> ; ; , . ; - : <br /> ; . . . <br /> VE��ILAT�,(�N , :. .. , : <br /> • . � No. . � � � Kitchen Exhaus� ducted .�eeuculat'in� , ' �cfm.. � , <br /> --�,—,-. —.--- , <br /> ' ' No. . ;. Barh,ExhausG (rr��st be ducted ouuide) ' �cfm , ' <br /> � , ,� . . . No.� � Qther�ans• Locations � � .. �- .d� , d 0 �� � .; . <br /> .���r o � ��F- �,� , U � E�. o o u. . <br /> ; . . � D4o :�'-. . , . <br /> ' ]E�S'��RAG� (MUST BE APPROV�D.BY FIR�MARSI�AL;) � . • : • . <br /> . � . . '�ristallation Removal - �. � <br /> . �. � '�.iel oil: gallons underground � inside ° , outside . � <br /> , ; . . ,LP Gas: • gallons . , . • . , � , . <br /> . , p�er Gas 4pening � . <br /> ' �� i. , , , . <br /> ; ; . <br /> ' PEI�2YT. F�E.�CUL�ON , , . : ; <br /> , . 1, 1.25%;of Co ti�t PriG�* or Mi imum Fee ($35.Q4� � ; . > <br /> ' . °! $so. �� x .O�zS �. ' J . 2 � . :1'� . <br /> , ' � � • (conuac�price) ,: , . . , , <br /> � <br /> 2, ate urchar�e. ** Add the State Building Code Div�sion: �� � ' <br /> , � Surch�rge to each permit. R 8 S p bo x ,OOQS $. � ..��I <br /> 1 � 4r $.50, whichever is greacer (con�racc price) , - . • , ' <br /> ; . , <br /> . � 1.50 � <br /> . �. � 3. " sta 'a�g� and �Iandlin�, (Only mail-in applications) $: ' � . <br /> . 4..� ,: TOTA;L PERNIIT FE� (Add lines 1-3.above)� . ; ; $ ; l �9 :�'' . : <br /> � , � ;. � <br /> , � * �ONT1tACT PRIC�or 70B COST means the acrual or estimated dolla�amount charged for the permitied . <br /> ' � .; work iricludin,g materiais,labor,profit, and other fixed�osts.�It is the aznotwt ta 6e charged to the customer. ; � <br /> - . '. for the work done; If any�riateiial,equipment, labor, or ins[a1la�ion are fiu�iished,by the owner,ccnsnc or <br /> � � Any atiier parry:the rea�onable market value of such items musc tie added co [he escirnaced eos�os coniracc <br /> ,- . � , priGe fQr permit fee Aurposes, In tbe eveni that there is 2 dispute on tlie ai�ount of.tlie.jqb cqSt,;the Ciry may .:" �. ;..; <br /> _ <br /> , <br /> , ; .,: requesc'che submission of a signed copy of the acn�al concrac�... , -. <br /> � , , � , , .. : , <br /> " ** The S'�ATE SUItCHARGE is .0005 af t�e contract price uuder$1;QOO;pQO cir. $,50-whichever is$reacer. . <br /> � For val�atiuns over$1,000,000 call the Dep3r[ment of Inspectional Seryiees for the price: ' , . � <br /> . I . '. • • '.: ., . . <br /> , ! . <br /> The undersig�ed h�reby applies co the City foz issuance oF a�echanical Permit, agrees to,do ali � ; . .,, <br /> � . . � - , wor,k in,scric.t accordance witl�the ordiriances of the City and the regu�ations�oF.the Minnesota. <br /> � • State�Building Cade; and certifies that all statements rr}ade on'chis applicatiom are complet�, true <br /> � and�orrect. � . , �. � <br /> � 1 .��X:on� i`// �s�e��yc" ' .,%5 p � • � <br /> � � " Applieant's�Signature: Date: , <br /> • - � ����.�nJ /w. .s(�.tA .S6 <br /> , Appr�ved By: ,. • , Date: � , . . . <br /> , , . '. <br />