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�s>-30-2GQ1 P3:ilpn frum-CITY OF �RONG +9922494616 T-133 P.aOT/OOT F-i�6 <br /> �`�P�ACES . <br /> Gas fact��replare <br /> Waod bttrning factory fir�p]ace with flu,e <br /> Waoa Stav� <br /> 'Woad stove with fdue <br /> Braud Name Model No. <br /> 1 ��ATION. <br /> . � i�io. / . T�itchen Exhaust ✓ d�d recirculating cfm <br /> �No. ?� Ba'th Bxhaust (�nust tac ducted ntttsi�) Z2So cfrn <br /> No. 3 Otiier Faas: Y..oc�tio�s vAarcusCses �n-�.oi) 480� r,fioa, <br /> FUEL STORA�� (MUST 8E APPRaVED BY FIRE MA�tSHAL) . <br /> Installati�on � Itcraoval � . <br /> fiael oil: gallons � underground 'i�side ouiside <br /> LP Gass: . gaUons <br /> .Other � � pas apeain,g <br /> P_EBMIT FEE CA�,�„�'�A�41Y � <br /> i. 1.25'� of�;����a� or Minf��un Fee t�33.001 <br /> . � �bo,o0 o x .0125 $ So 0 0. <br /> . - {eoauaas pric�) <br /> 2. � SL��+A�. **Add tl�State�uildiag Code Divisi�a <br /> ��, <br /> . �rchargC.to eaCh patrait: � �f�,o0 0 � x .00bS $ ' �O- <br /> , or�.50�'W1]IC�1CYCr 3S �TC8tL`i {cancract pricx) . <br /> 3. Pasta�and 1"�andlin� ((?nly nn�Il-it�app2icati0ns} $ 1.50 <br /> 4. TOTAL 1�lZMTT FEE �Add liaes 1�3 above} �$ S�o!.s o <br /> "' C�NTRACT PRIC6 a 708 COST means tbe ac�or estimated,doIIar amo�u�tt chargaa for tbe permitted <br /> work ia�cluding ma2eriel�,labor,profit,a�d aher fixed«�ssts. It 3s tbe atato�to be c�rged to tha customer <br /> for tha woaie da�na. If any:aaterial.�eq�iFmeat.labor,or ins�aIlatia�a.-e fiumsh�d.by t�ue owner.cenaac or <br /> �/bth!!pRllY�3C�EAQ0�10 Ia�L�=V�1i0 Uf 9DC�1tCm3�1LZSL bC��1A QSC OStl[OdtOd COSZ OC COACTaC[ <br /> gr�cx,for permii ffiecc pu�poses. ia t�e ev�at thu there Is a diapato oa t�e amonut of the job cost,tho Cicy.may <br /> � request t6a subu:issioa af a sig�ed cc�py ot thc actual ca�tra�t. � <br /> '"* The S?AY'�SUR�iiA,Rr3F is.0005 of tha contraat prioe uader$1.Q00,000 or S.SO-whicbev4r is grta►ttr. <br /> For vah:ations ovox$1,000,000 cait�be pepucnent of I�aspectiooaal Services f�tl�price, <br /> The�undcrsigned bereb�s.pplies m the Ciry for issuanco of a Mech�nical Permi�, ag�rrees to do�1] <br /> work in scrict accordance wfrh the drdinaaces of the Ciry and the regnl;�tions of tbe I+rtinnesota <br /> Srau Bailding Code, and certifi�s that all statements m�de on this application ar�completc, true . <br /> a�d cornect. . <br /> � <br /> ApP1�cant's Si�naturc:.. �''-- T�atc: b���}O1'�� <br /> Approred By: �$t�: 6-f 2-a c <br />