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<br /> pCT-29-Z003 15�03 P.05
<br />�QOLING SXSTEM05 � . , , . , '
<br /> Q�t� �, ;--r=. .' �.----- f��j . , . ,I'.
<br />,!Hla1cE: . . ' � �:lRZrCiY , l.N J;Q�i j� �'. � . ' , ,
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<br /> Moeei:� � ��Z�c'��n,.��4. . ��KC:S. - .
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<br /> Tons: . '. . ' � `,."' �—.'=.'.'
<br /> H.Powa� __ �
<br /> ..., P AC,.�
<br />, Gas factory 5rcplace ; ` . .
<br />:.; �:. Wood biumn�g factory firc�lact with flisa , .
<br /> vV'ood Siove � . � ,
<br /> : �' 1�Vood stovE;with tlue
<br /> Brand Nanr►e, _..r,..__ Model No.
<br /> �v�rr�_]Q,A.�'I4rit
<br /> No, Kitctfen Exttaust,,,,,__duat �reca3cvlating ofm /� i n�tr.l
<br /> ' .No.„�:$ath fixhausE(must haye duct outeide) �^c�an �•!t2✓ ��U G�P/�7 SdZc.rG4/x'
<br /> : No: dther Fat►s:Locatioua�. , cfm .�p ��ot�ru .
<br /> . ��.���J
<br /> FU'EL 3T0�(NNST BE A,P�'RO�D BY�RE MARSHAL)
<br /> Installation or R�emm�val �
<br /> flul oil: gallons undergi�ouad inside oartside .
<br /> � LP.Gaa: gallons
<br /> Other - - --Gas°p�►1»g
<br /> .
<br /> PE12NX�'�'F`F,E.��12��LY(� ,
<br /> �Z,._.S_tste Ltute Yes Tb�ie 4�on AppBes �
<br /> Itie replacanc»t of a Ytesidci�tial_flxture or anbli��ti�t mects a1.1 tlu+ee of thc following rcquircnn�nts:
<br /> 1) D�g t require x�dification to elecu�ica!or gas service.
<br /> 2) Has a total coat�f$500.00 or less;accluding the cost of the fiatu�or apPliance:
<br /> a».d ;
<br /> 3) Is improvod,it�stalled or replaiced'by tho hameowucx or licer►s�l co�ntsactoi'•
<br /> Skip ruact section; Coat o£Pcrmit ffi,�,,,,�,�.00 :
<br /> State Svrc�arge S .50
<br /> Mait-In Fee $ 1.50
<br /> ,'f�bove does not apply,follow guidelincs below:
<br /> l: Cont�act Price*is.0125%of job with a M{n�mq�n.Fe�,ot(S35•00)
<br /> �,�P�a X.oin s a�o.(�5
<br /> (contract�nice) (minimunn$35.00}
<br /> ;.��St�e��,"'�Add tl�e 5tate Building Code Di�►isxoz��Mioimmou._�'ee of(�.50), �
<br /> ��Wi��aZ x.00Os $ 8''T 3
<br /> (contract pricc) (minimum S.Sa) �
<br /> �ttp://www.ci.nrorio.tnn.us/mechanica]%20permit.httr►1 ]O129/20(33
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