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`''' 02�03/93,� 11 t 52 TF� C I TY OF OF20tJ0 612-A?3-?35? 003 ,
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<br /> WOOD BUR�YING BQiJIPM$NT ,
<br /> ;� � Wood atov,e,wlth flue • �
<br /> Wood combinatlon or add-on GpS D`�� v�� . -
<br /> ,, � Factory;tlxepieee wIU� liue Mn�o
<br /> '# Pactary,Fireplace (�) � I�reeatand ng nr7' .
<br /> � Wood Stove: (a) � Pranklin, other
<br /> � Brand Name -�-�� Model No.
<br /> h4fgr'a Mln.� Cleecancea� aide " , rtar Z'�_. min. flue dlA. O. . ��-S�
<br /> .GaS C��N6cC�o� � c�tt�6�S Toc�
<br /> VEN'TYI,AT�ON
<br /> No. Kit�hen Bxhauat ducted � rccltculatU�g � cfm
<br /> No.. Dt+th Tsxhnust (mu�t be ductcd ou��idc) cfm ctm
<br /> No. __�__�, Other Faru: Locetioru . _---
<br /> Tofei
<br /> iri1F'L STORAGU (MUST HB APPROVED HY F1RB MARSHAL)
<br /> � � Instal(allon _ Removel ,
<br /> Fuel oll� gallons underground ___ lnslde outslae
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<br /> LP Ciaa; _ Bulluru C�es opetilng
<br /> Other
<br /> �� gERMIT FEE CAj,CUI.ATYOI�I / � c � '3cj�OO
<br /> �` 1. 1.2596 of rontract Pdc�'� or �fntmt!m Fee (535.001 �
<br /> 2, 5tate Suc�har�._ �'" Add the Staue Hullding Code Division S �
<br /> � ' ' Surchargc to edch permit.
<br /> 3. ���Qe end HwndltuA (Otily mall-In appticetlons) �
<br /> TOTAL PBRNQT;pgB (Add ilne� 1-3 above) S S,
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<br />`���Y ��`"1°�='� '��= * CONTRACT PRICB orJOB COST me�ns ihe�tc�ud o[eitlmwted doll�r amount chuscd for�hc perTn11ta1
<br /> r`St � work lncludlna nutetivi�'I�bor� protit. wd ochec tU�ed con�. lt l� t6e iunount to be ch�rg� �o �,o
<br /> � � � customer fot ihe wo�ic done. If any m�teNv� equlpmeat� I�bor�or ln�t�ll�tlon ua tlical�hed by the owner,
<br /> �± � tenant or any other puty the �on�ble muket vdue of such feenu must be �dded to the es�lmaied cosc
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<br />`���`•�` �: :`' � ~ r vr contr�ct prta tor permlt fee purposa. Ln the eveat th�t thtro li�dispu�c on�hc unoun�ot�hc Job cos�,
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<br /> �, . Wc Clty m�y teque3t,lhE fubntl�floa o!t �IgnM Copy o[the �cN�l contr�ct.
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<br /> :�',,�.; The STA7B SURCHAROB Is •0003 ef tbe eootnct prlce under 31,000.000 or 5.30 - whlchcvcr Is
<br /> "�+' goeater. Fot v�lwtloni nver 51,000,000 ea11 tbe Deputmeat of InspectlonU Servlcet lor the price.
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<br /> ' The undersigned hereby�applles to the City tt�r iysuuocC uf a Mecuatilcal Permlt� agcees to do
<br /> �:���:., �. all work in atrict accordance.with the ocd[nances of the Clty And the regvlatlons of che Minncsota
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<br /> `�•;:,=, •�- `-:Sta�e Building Code� and certl[ies that ail atatements m�de on thls appllcaclon are comp ec�► �G
<br /> :��';. and cornct. . '
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<br /> Applica�nt'e Signature:
<br /> bato• �,_�____�
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