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7-16-201 10:� FROM PURCELL PLUMBERY 612 271 a23a P. a <br /> vau •. •��i i• •a�w i ���u •�i� .r •i�n• ..�• .�.�. � �.. . ..., .., � ... <br /> � � � \ <br /> � <br /> , � <br /> ��REPLACES � <br /> Cxas factory fireplacc <br /> Wvod buming factory fireglace with flue <br /> wooa sco�►e <br /> Woad scove with tluc <br /> . Hraa�d 1�Tame ARiodel Na � <br /> 1/',�J�!/��2 �ga-Go .o�..C'y ,G�r,2. �Dr'C�-�i�iu <br /> �+'�N�.,A,�TI41�I ��� <br /> No. � � Kiuhcn Exhaust �aucted reciresYtating cfm <br /> �No. � Bach�x�aust (mnsi be ducted autside) cfar <br /> " . No. OtF�er Fans: Lvcatioas " '��a� <br /> �L STORAG� (MUST BB APPROVED BY FQZE MARSHAI-) <br /> InsCallation �� Removal ' <br /> Puc] vil: gallons �ndergrowld �inside wtside <br /> � LP Gas: . Sallons <br /> •.Ot�er Gas opex�i�g <br /> PE�ZMTT FEE CAY.C'(JI.A'L� ' <br /> 1. 1.25�o of Cantt� Pri� '� or]�ri 35 <br /> . .S X .oi�s $ ��._ <br /> t�o���� - <br /> Z, s . �*Add the State Build' Code Division <br /> S�r+charge to each pr.nnit. - �� "'� x .0005 $ � � <br /> or$.50, whiche�er is greater (coa�act pcia) <br /> 3. Posca�g and Handlmg (Only mail-in appl�catioas) � $ • .50 <br /> 4. TOTAY.PF.l2MiT�EE (Add lines 1-3 above) � <br /> • CONTRAC7 PRiCE or JOB COST m�eaus tbe mctual or esdmated eo�llaf amouat chargcd For We permitoed <br /> wn�k including�nacaial�,labor�Profit,aad vttia�ixed ooscs. Ic is rht aaeatnr tio ba eharged to the evseo�aer <br /> 4'or�he work dosa i[aay materiai.�quipu�at.labor,vr m5u�llation ara lVunis�od by the owraet.teaant oz <br /> say a�ha party'ttie rcaiousbk markrt value af suck items must ba added to Qie eetirnated oost or cvntrnct <br /> priee.lor peisnic fee purposec. !a the evea[thac there is adispuu oa tbe amoua=of rbe job cost.tI�Ciry.maY <br /> cequest the subcnission oF a sig�d copy of�ha actual co�uact. � <br /> +� '[Ttie STATE SURCHAR�OE is.0005 oi tl�e caauract price unda 51.000.000 or S.SO-whichevtt is greater. <br /> Foc valuatioaos avcr 51.000.000 call tIx Department af Inspeational Servicea for t�e price. <br /> �'he undcssig�ed hereby applics t�o the Cit�for issuance of a Me�ba�aical Pernut, agrees to do all <br /> work in s�rict accordancc with tbc ordinanas of tlie Cfty and the tegulatians of the Mitu�eso� <br /> Scace Buuding Code. aAd cert� s tbat all srate7necnts made on this applicatioa are complete. uue <br /> and correcc. <br /> Applicasu's Signa 4� � Datc: <br /> Approved By: Date_ <br />