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blI 1 Vr VRVI\V � VILG`t/'Tv�v vri �i� vv ��.�� � .v.iiv� ��v. i�.� <br /> .� • ' ' , ' . ' ' . , , . . . . • � _ � <br /> . ' ..WiY1_i1L11_i/li .. �, ' ' , , ' � • . � . . � �, . � . <br /> . . . . . Ga9 fi�:u�ry #ireplace . � . � � <br /> � � Wo��d burning factory frre�lpce with flue � <br /> . � • ,�Vf)Of� $EOVC ' . <br /> . ��:wWa �to�� w�c��flu� . . <br /> . � �DFxnd Nam�.: � . . Made1 Nn. � <br /> � V'�L�iT[LATION . � � � . , . <br /> � � �.iefci: Kitchen Fxhuuyt ducced: � recircuIating cfm <br /> � No�. _ Hafh �xhaust �mu5��au�tea ��s�a�> c�n '. <br /> . : � No. _ Ucher Funs: �.ocatiqns cfin <br /> � :. ���j; .� �TUeAG� (MtJST BE APPRUVED 8Y R�r MARSHAi,) <br /> � inskaUacios� , .Rr�i�u�} . . . <br /> _ Fuel oil: : � gall�n9' underground inside outside <br /> � __ LY OHs` gartans <br /> `Other . --- Csas_cZpeiiuig <br /> — ----- <br /> P�R�3���.F c�cUL��iox <br /> 1,. l..?S% uf�vntract Pri�e* �r�Vii�i�nttm Feg (S�S.(}Q) <br /> �5'<<<��jF'�;�` x .t�t2S � ��=, ,rj.�; <br /> (conuact pricel <br /> 2. �Is�{�,S➢;I�L�1� '`*Adct thc State Bt�ifding Cocits Divisi�n � • <br /> �urchArge t�i�aeh.permit. __�� � x .00US ' $ `7,. � . <br /> � ar $.50, wfiichever is grcater rrunirocc prlce> . <br /> � 3. �'►�tagc and Ilandli� e (On)y mxil-in applications) $ 1.S0 <br /> �.. 4. , � TaTA��i'ERMIT fE� (Add)i�ies �-3 atwve) $ // ���L_ <br /> : '' CONTRACT PR{CE or)E}8.C�.ST mean�t Elje ac:tual�r rstimQted dnllaf$mtrant cherged fUr tllt pe:iuiitrd <br /> work inctuding maccrials,labor,}�rofit,atui uthec fixed coscs, l�is clic aniaunc io be ci�asged[o thr cusswmer <br /> ' for the wsuk d«�Ne. .it any maFeris�. rquipmont;]abor, ot issrallatioa uc ftutt%�ked by thc olviscr,tenant or <br /> any other pacry the rra�oaabfe m�irket valut i�P Yuch items musc bt acitiezl io the actimateii cosc os contsaa <br /> . �ciee.Ccir}iermit fee pur}:dse3. ln r)le svera tihac therc ig a�3is�wwtr c>n tbe enxwrx nf thc job cosr, the Ciry may <br /> '., �.. . tequest!hc 9ahmisyiun uf a signrd cupy ��f'the actual eornraci. . <br /> �* "ll�e'STATE SLl1tCHARGF ir .l)005 of the convaci;prier un�icr S1.W0;O(N.l or .�:50• w6�chevcr is gre�tcr. <br /> � f�t�f Y,Alll4tta►1�uv�r SI��QQ:OW cail�e Departjuenc af Ia,specaocia!-3ervices fiu[heprica. <br /> Thc uncirfsigrt�d h�reb� app�iEs to chr City tqr��ssuane�v}'a Mechaniral F'ermit. agr�es to d� all <br /> work in:strict ac�E�rda�icc with tl�e ixrclinances Qf(he City ai�d che rc�ulati��ris af the Minnesota <br /> �it�te l3tittdirtg f'ode, and ce:tifi�s that a(1 statertients made an cbis a�plicacinn �re complete, true <br /> and corre�:t. <br /> � A�plic�ut's Signature: : � � �c..��(,l �at�: �-Z��-C�} <br /> � ; <br /> Apgru�ed�3y: S . �;,;,_ . � . �: � �..�:; <br />