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l.l l T Vt' VKVIVV HYYLil,H11V1V t'VK 1Vl�l,t1H1V1l,HL Y�K1V111 Yage 2 of,3 <br /> � �. <br /> ` l . <br /> f <br /> t • <br /> COOLING SYSTEMS f <br /> �� <br /> Quantity: <br /> Make: �—�� <br /> Model: ���� <br /> Tons: 1� <br /> H.Power <br /> FIREPLACES <br /> GTas factory fireplace <br /> Wood burning factory fireplace with flue <br /> Wood Stove <br /> Wood stove with flue <br /> Brand Name Model No. _ <br /> VENTILATION <br /> No. Kitchen Exhaust duct recalculating cfm <br /> Na�Bath Exhaust(must have duct outside) �cfm <br /> No. Other Fans: Locations cfm <br /> FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHAL) <br /> Installation or Removal <br /> Fuel oil: gallons underground inside outside <br /> LP Gas: gallons <br /> Other- Gas opening <br /> PERMIT FEE CALCULATION(S) <br /> 2002 State Statute Yes This Section Applies <br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> 1) Does not require modification to electrical or gas service. <br /> 2) Has a total cost of$500.00 or less;excluding the cost of tne fixiure or appliance: <br /> and <br /> 3) Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip next section; Cost of Permit $ _ 15.00 _ <br /> State Surcharge$ .50 <br /> Mail-In Fee $ 1.50 <br /> I�a�ove Toes not app y, o ow gui e tnes e ow: <br /> 1. Contract Price* is .0125% of job with a Minimum Fee of($35.00) , <br /> --- - --�--- � ,�- ` ���> , <br /> - � __. <br /> ��j%('_� x A125 $ � �_,� ------ <br /> (contract price) (minimum$35.00) <br /> 2. State Surcharge. ** Add the State Building Code Div�sion aMinimum Fee of($.50) <br /> -�<r _ ---_--------- ,._ - <br /> -_------- ! � .` - <br /> ��' x.0005 $ � � <br /> file://C:\Documents%20and%20Settings�nimi\Desktop\CITY%200F%200RON0%20APPLICA... 7/31/2003 <br />