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Au�-29-20G0 09�1�am Fra�-CiTY 0= 9RGN� +�52249d616 T-46� ?.�GS/005 F-074 <br /> � <br /> - �PI,_ �C�S <br /> Gas factr�ry f�Fep�ace - . <br /> W'ac�d 6urning f�ciQry �ireplace wit,h flu� <br /> . Wo�d St���� <br /> � Vdc��,d $Cove wiFl�.fiue <br /> Srand�Vame Mod�11�o. <br /> �' �TI ATi�, ' . <br /> No, � I�iGci��n Exl�aust ci�zct� r�circulatin <br /> _V� � � c.fm <br /> .�ath �xhaust {�i�st be ducted outsid�} �� <br /> I��. ,� ,p C7rlxer�ar�s: L�ca�ions �_ cfm <br /> FI.�EY. ST�R.��E {�1�TST BE �,,PPRd�%ED BY �I�E ?��ARSHA�,) <br /> , Instaila�ion Removal <br /> � �ue� c�iI; gallat7s und�r�round znside outside <br /> Z,F G�s: g�lans � —�. <br /> Q#h�z _ .. C'aa.s op�n�g <br /> �'ER'b1�T I�E CAT C�'LATION <br /> �.. 1.?5� of�ontsact Pri��* or _ 'nimun e . � 3 Q <br /> �-:x��?� C � ` x .t�I2s $ <br /> (c�ntracc price) <br /> �. . �.te ���rchar�e. �M qdd the State Buii in� �o �.�i�rsi�n <br /> Surcharge to ea�h permit. =�� .,G �c_ x _G�05 $ <br /> or $.50, wh.iCheveC is gre�t��• . (conrract price} - T <br /> 3. �'asta�e and Handlin�; (Qn1y r�i�_i� �ppIi��tians} ;� � <br /> 4, TUTA�.PEItMIT FEE �Add lin��s 1-� abave) � <br /> * CdNTI�A�T PRZCE or Jd�COST means the actual or estimated dollar amour_t aharg�d for tt��gecmitted <br /> work incfuding ma�ria.is, Iabor,pxofit, artci o[her fixed cascS. It is the a�nount ta b�char�ed ta�e custorncr <br /> for rxze wQrk dana. If auy material, aquipment, labor, Qr instal�ation are iurnished b��the owner, cenanc oX <br /> any��et p�rry ttie r�aspn�bl�: msrl�et value af s�ch i�s�us must�e added to r1�e eg������L�sc ar con�ract <br /> grjee t4r permic S�e purp�ses. In the event that there is a disputt on the am.s�un.t of the job tast, CIs�City mdy <br /> r�quest the submissior�of a sigried��py t�f th�acteaal c�nT_��Ct. <br /> "* "Ihe STATE S�I7RCHARG��s .�UCtS of rhe eanu'a�[priCe uac3et$1,00{},�4Q ox 5.50�whichever is graater. <br /> �'or valuation�,aver $1,Qt�0:4Qt}c:ill th� Degaztmant af Inspec�ional Servicea fQr the price. <br /> `i'Iz�undersi�i�ed her�by app�ies tcr tY�e �ity for issuance �f�Meeh�cal Pennit, agr�es to do a,I <br /> work in stxict accordance �vith the ordinances of the City and th� regulations of tt� Nlinriesoca <br /> Sra�:. ��iXding Code, and �.el-ti�es that all. statemenks made an this aFplic�taon are cc�u�gl�t�, tru� <br /> aztd c4rrect. . <br /> AFplicant's Signature; Date: � �. Vv <br /> Apgroved F��: Date: <br />