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Ncv-O6-2001 02:iTpm Prom-CITY OF ORONO +p522494616 T-136 p.p03/�03 F-857 <br /> t`�'`� <br /> .t <br /> FIiZEPi.ACES � � � � �`—�2� <br /> __ {}as factory freplace <br /> � Wood burning factory firepiac� with flue <br /> Wood Stov� <br /> Woad stove with Aue <br /> Brau.d Nazne Modtl�To. � <br /> `VENTILATION. D� � <br /> � I�o. � Kitchen Exhaust ducted rreccirculatu�g - cfrn <br /> N'v- Batb Exhaust {must bF ducted outsic�e) cfm <br /> No. �ther�s�s; Locations �� <br /> FUEL STDRAGE (MUST H8 APP�tdVFI� BY PIR�3 MARSHAL) � ��.�•._— <br /> I�c, a� <br /> Installation - Removal ` <br /> Fue1 oU: � �allans ,�� undcrground _ inside autside <br /> I.�Gas: gallans <br /> �> �}th�r � �as ppeni�g <br /> pFRMIT F�� CALCULATION <br /> 1. 1.?5°� of Gan�act rice* ar���m�e ($35.d0) <br /> x .Oi23 $ <br /> (r.oauract price) <br /> 2. Stata S�r�haree. **Add the 5tatc Bui(ding C iv�si�n <br /> Surcharge ta�each gcrmit. �5 `7�� �� x '.Q005 $ � <br /> or $.SU, .whichcvcr is gre$tet (con�ract price) <br /> �, Posta�e and T�andling (OnIy mail-in applications) $ 1.50 <br /> �+, TOTAL PERMIT F� (Add linrs l-3 above) $ <br /> * CON'r']tACT PRICE or JQB CQS'T�ans tht actua]or estinaatad d�sllar amounz ch�rgr,d,for tlze perm.itted <br /> work including materials,luboc�pmftt,aqd ott�er fixed eosW. It is the amovnt So 3�ch�r��d tn thc custQmer <br /> ior ihe war�dbn�. Yf amy material,�equipmer,t.labor,or insialla�oe are fitrnisbad by tlie owner,:enaat ar <br /> any o�het gart}P the roasoaabl�marlcet value s�f such iu�must be added to tbe.e9timated ao�t ar contr�ct <br /> price_f�t peru�it fee parposes. In the�event that t3�ere ie a disputt on thC ttmount of thc job cost,the t�ry Fnay <br /> r�c�':�cst the submissioa of a sigaed copy oP the actual COAtra�t. , <br /> ** The S'T'ATE SU'R�HARGH is .0005 af the contr,act price tmc4er�1,000,000 or 5.54-which�ver ls greac�r. <br /> For valuat9ons over S1,OQ0,000 call the Doputr�ut o;Tpspectional Services for the pricc. <br /> T�undersigned hereby applies to[he City fur issttaiu:e of a Mecha.nical Ptr�it, agrees to do aEI <br /> work I� srrict accordance with the ordinance� of tht City a�d the �egulations of thP htinnesota <br /> State Building Cod�, awd oertifies tha,t all statr.�nents made on this a��[icatioa are c,omplere, true . <br /> and c,orrect. <br /> Applicant`s Sigr�attue: � Dat�: 1 � l� —'d � <br /> A�proved BY� bate: <br />