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. .N�:-29-2001 12.02pm From-CITY OF ORONO +9522494616 T-259 P.003/005 F-215 <br /> FIR�p�ACES � � . <br /> , Gas fact+ory firepiace � <br /> 'VVood burnir�g factory fireplac� with flue <br /> Wood 5tove <br /> Wood stove with flue , . . <br /> Brand Name � Model No. � <br /> VENTILATION � . . � • . . � � . . . <br /> No. � � Kitchen Exhaust ducted � recirculating cfm <br /> �No. � Barh Exhaust (must be�ducted outside) cfm <br /> . No. Other Fans: LocaCion;� " � - . � �c� <br /> FYTE�STQRAGE� (MUST�BE APPROVET� BX FT� MARSHAL) . � <br /> Installation -� Removal � � � � � <br /> � Fuel oil: .gallons �^ underground inside outside <br /> LP Gas: , galions , . <br /> ..>.Other . Cas opeiung <br /> PERMYT �E C�LCULATION . � <br /> Z. 1.25% of Contract Price* or ini m Fee 35.00 . <br /> <<. <br /> � j � �� " x .0125 $ "��_� —�. <br /> � � (co,uract priae) <br /> 2, te Surchar e. '�* Add the State Building Code Division c;�,� <br /> . . Surcharge to each pe�mit.• : �,�: �`��1 x .0005 $ . _ __ <br /> or $.50, �vhichever is greater (conuact price) . � . <br /> 3. Postage a d IIandlin� (Only mail-ul applications) . . $ �,� 1.54 <br /> 4. TOTAr,PERMIT FEE (Add lanes 1-3 above) $ �1. `-`-`"'- <br /> '" CONTItACT PRICE or]OB COST means the actual or estimated dollar amount chaxged for ihe peralitted <br /> work including materials,labor,profic,and other fiaed coscs. It is the smouat w be chazgrd to the custaaner <br /> for[he work done. If any materiai� equipme.��t, labor, ox installation are furnis�ed by the owuer,tenant or <br /> any other psrty thC re$sonable mat'ke[value�,f such items must be added to the estimated cast or contiact <br /> . pr'sce_for permit fee purposes. In the event that�here is a dispute an the auiouat of the job cost,the City may <br /> reques� [he submission of a signed copy of th�;actual coniract. _ <br /> "'"` The STATE SURCHARGE is .00OS of the con[rac[price under S1,d00,000 ot $.50-whichever is greater. <br /> For vaIwa�ions over$1,0�0�000 call the Departmen[of Iaspectional Services for[he price. <br /> The uncEersignEd hereby applies to the City f<►r isstt2tnce af a Mechanical permiC, agrees co do all <br /> work in strict accordanee with the ordinaneEs of the City and the regulations of the Minnesota <br /> Scate Building Code, and certi�es that all sta�emenis made on this application are complet�, crue . <br /> and correct.� � � <br /> ..- <br /> , � -` � Date• c• <br /> . APPlicant s Signatttre: � �����-��: 1 ��� ,� i i I Z i � C�L <br /> ApprovedBy: �t�,-.��`�^"r ��'�I'"�'�� �� �—__ Date:� i� 2 �3 �/ <br />