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. Rp� 22 2010 12: 30PM HP �RSERJ:ET F�K p. 4 <br /> . � <br /> ,d; 3 i . � � ' . <br /> ; C. �, ' � ' '�j ,�` <br /> t '� <br /> 0 Yes,this section applies - �; � , <br /> • � �. <br /> Tbe replace�ncnt of a�,?�fip��i�ct�*e or afmlienoe rthat meets all three of t�e fiollowing requir�meata: <br /> 1. �1 requse modi�icaticam to electrical or gas servica ' . <br /> 2. I�as a�of SSOQ.UQ or less:QXGhI$1T�fhe�et of the fixt�m or applisnae:and <br /> 3. Ia gaproved,inatalled or replaced by the l�omeowner or licensed ooatractor. <br /> Sicip aext sectiQn,if this applies; Cost of P�'mit 5 15_00 <br /> Stato 3urcharBc �, .50 <br /> , Mail-In gcc(if AppGcable) S 2.� <br /> Total Permit Fee S <br /> ;i ; i , i. <br /> If above doea not apply;follow guideluies;'belpw: ' '; � � <br /> . • y• r .. - . . <br /> � 1. �ONTSAGT PRICE .'is 1.259/0:0�contract!p�ice with a(Miaimam Fee of 550.00) <br /> s ������ . 4�' ; �t.0125 S C��i�`� ✓�•(y d <br /> t. ,°(cooa�ct p¢ioe) (rnioimom SSU.00) . <br /> ° �� .' <br /> 2. "`"pdd the State Bldg Ccde Div. Surcharge(Nnalmum Fee of 5.50) <br /> � . 3�a v0. DC� x.00�s � l��� <br /> ' � . ' (wntrect pric�) ' . (minimum$ -50) <br /> 3. P03TAQE&HANL?L'ING(Only on Mat1-In Applicatians) $ 2.� <br /> 4. TOTAL PER11dIT F�E(Add.Lines 1-3 Above) � ✓ l ��d . <br /> ■ • CONTRACT PRICE oz rOB�CC1.ST meane,the actual or estimaked doUar atnount charged foa�the <br /> permitted w�ork incluciing materials,labor,�xoSt,alnd other fixed coats, It is the amount to be charged <br /> to the customer for thc'wark dona If any material, equipQnen�lebqr or installetions are fiuttis6ed by <br /> the owner.t�ant or any o'thes party,the reagoaable marlr.�value Of such items anist be addod to the <br /> estimated cost vr contract price fo��p�annit fte �wpo�e�s.' 'I[�the �vart;fihat dicre is a dispube on thc <br /> amo�mt of the job cost,the City may request thb submission of a signod copy of the actual contract. <br /> ■ **The STATB SURCHARGB is.00bS�of th�$uilding,Depa�mient at(952)249�600 for thc price. <br /> ; � <br /> - �� � <br /> . �' - ,. .' <br /> T6e undersigned hereby applies to the City.for iasuance of a Mechsuical Permit, agrees to do all <br /> work in strict accordance with the ordir�cea of the City and the regulations of the State of <br /> Minnesota, and cartifieg that all statements made on � application are complete, true and <br /> correct. <br /> Applicant's Signatura: Data: C r �� �� <br /> 3' � , <br /> , <br /> . � 'w ' &� .; <br /> . ' <br /> ; � ; ; � , .. � <br /> � , . <br /> , r � <br /> �, <br /> � <br />