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CiT� Or ORONO � 612249461n Oo/20/QO 08:18 � :04/04 N0:458 <br /> . <br /> F'Ilt�.E�,L�c� <br /> Gas t'�etory fii�p�ace <br /> T..._. 'UVoad t�urriing #actory ficepl�ce with f7ue <br /> � Woud �t�ivc <br /> '�V�ocxi scove with t)ue <br /> Brand N�me M�del Na. <br /> �1�TILt�TIC}N <br /> No. Kitchen Exh�ust ducted recirculating � Gfm <br /> No: B�ch Ex�aust (.tx'ius[be du�ted outside) cfm <br /> No. � O�hcr �ails� Locat�ans � Gfm <br /> F�L �,'TO�ACE. (t��JST BE APPROVED BY FIRE MARSFIAL) <br /> , It�stsllntion Rernovai <br /> Fuel oiL• _ gallons undergi�ound inside outside <br /> LP Gas; � gallons .� ' <br /> � Othec � C3as.openin� <br /> P��1IT �'�E C'��C�,,4TIQN <br /> 1. 1:25%a.of Cantra�t�'r�ce"` ur Mln�mui�F��$ S.p 1 <br /> _ 36'{� x .0125 � �{5.5 9 <br /> � {contracc�ricG) • <br /> 2. �f,�5uzcli�rge: ""' Adc� the St�te Bt�ildir�g Caie D�vision <br /> St�rcharge C4:erach permit: 3�K � : x .0005 $ . �• � z– <br /> ot $.SQ, wk►ichever is g�eat�r (concracc,pdco) <br /> 3� P�4taae gnd H�ndling (On�y �wil-in applioations) $ — 1.50 <br /> . 4. TC�TAI.P�RMIx FEE (Acid li,►�es l-3 �bove) $ K� q� <br /> * tvONTRACT PR1C�nr)�B CC1ST tneans the uctual or estimnced ciollar amounc chsrg�d foc th�permiTted <br /> wc;�k includ'rng v�aterials;Iabo�,profii,and nther fixed eos�a. lt ts che aniaunrco tx.charged[p thc cuatomer <br /> for:thc wark d�ne. (f any mstcrial, equipinent, ls�bo�,or inistallation are furnishcd dy the owncr, tenant or <br /> n�iy othe� party the reasonafi�k mLrlret vfllue af such i�omK.must be addctii io the capmnced cost or co�vac[ <br /> price for permit fCc:Purposes. ln th4 event t11at there Is a dispuce un tht srn�unt of d�e job�oyr, the City mAy <br /> rryuest ihe suhrnissiim af a signed copy af t�ic actunl conLrac[. <br /> """ T}te STAT�SUT�CHARG�is .Q(xl5��f the contf�ct pric�undcr�1,DOO,E)00 or �.SO - wMichever ie grearer. <br /> F'�r vatuation� aver�.i,QOc);Ot)0 cAli the Departmen�of lnspact'tonut Services fot the ptiec. <br /> The undetsinned hereby applies to the �ity far �esuanee ctf a Ivlechatucal Perm3t, a�reos to do all <br /> wark iti strict ac�urdaflce w�th thc ordinanc�s of thc City and the regulations of the Ivi.innesota <br /> Sta�e Bui]cling Code, :�nd Cettif:,s that all statements rnade on this appt�caticm are cotnplete, true <br /> pr�rl correct> <br /> A�p��icatYt's Sign�ture: �'���,n�}cf�t" � �� Date: !c z4 0 <br /> A�praved DY� Date: <br />