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, 11416-'15 15:31 FROM- T-438 P0003/4007 F-778
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<br /> Q Yes,this section applies �
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<br /> The replacement of a ltesidential fixture or ap��iance that meets al!three of thc following requirements; '
<br /> 1. Docs not require modifcation to electrical ar gas service. �
<br /> 2. Has a total cost af$SOO.OQ or less;exeludin the cost of the�xture or appliance:and ;
<br /> 3. Cs i►nproved,installed or replaced by the horneowner or licensed contractor. '
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<br /> Sklp ncxt section,ifthis applies; Cost of Permit $ 15.00
<br /> State Surcharge $ 5.0(1
<br /> Mail-Cn Fee(If Applicabl�) $ 2.00 ,
<br /> Total permit Fee $
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<br /> °,�t.'fN:r. :�.-�'f.�,�4i,�.�< :�d�kC/��'�'%r `:G '��'+�V�ATI�lr S .�T3�V��U;.�aY.F`,.�R��D.?QN V�.:. �$���,l�'a i q � i'
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<br /> Tf above does not appty;follow guidelincs bolow: �
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<br /> 1. CONTRACT�YtYC� *is i�5%of contracC prict 't a(1Vtinimum�ee aP 550.00) �
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<br /> 1 ,�c;:olzs:$' ::'.`�.;.::;;.;..::; . ;:;:....
<br /> ;(con�ractppca)� '(mini�uom.i$0.00)'I
<br /> 2. STATE SURCHARGE 1 � ��
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<br /> /�x�;4�Q5'',��
<br /> �{eontr�ct prico)�
<br /> 3. POSTAG�&CIANDLING(Onty on Mail-In Applications) �$'���2.00.>.� �;:':`��:�`'��i
<br /> 4, fQ'�'AK,,p�RMTT FEE(Add Lints l-3 Abovc) +$:�, ��' '�"�
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<br /> ■ '� CONTRACT PRICE ar J013 COST means the actual or estimataA doliar amount charged for the �
<br /> permitt�d work including matorials,labor,profit,and other fjxed costs. Ct is the amount to bc charged ;
<br /> to the custoroer for the work done. If any material,cyuipment,labor or installations are furnished by ;
<br /> the awner,tenant or any other party,the reasonable market�valuc of such items must be added to the
<br /> estimaCcd cost or contract price for permit fee purposes. Tn the event that there is a dispute on the ;
<br /> amount of tht job cdst,the City may request the submission of a signed eopy of thc actual contract,
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<br /> The undersigned hcreby applies to the City for issuance of a Mechanical Permit, agrees to do all �
<br /> work in striet accordance with the ordinanees of the City and tha regulations of the State of
<br /> Minnesota, and certifies that all statements made on this application are complete, true and
<br /> coirect.
<br /> A.pplicant's Si�nature: t.G''R.l�(/ L�J`�/�i^GYL�'l.G�'/^ rpati�::� 1 ` �,�
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