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<br /> Q �S''es,this sectiqn applies
<br /> The rep{acement of a Etesidential fixture or annlianG�that meets all three of the following requirements;
<br /> 1. Does not require modificatian ta electrical or gas serviCe.
<br /> 2. Has a total cost of$500.00 or less;excludin8 the cost of#he fixture or applianct:and
<br /> 3• Is improved,installed or replaeed by the homeowner or licensed conttaetor.
<br /> Skip next section,if this applies; Cost of Pennit $ 15.00
<br /> State Surcharge $ 1.00
<br /> Mail-In Fee(If Applicable) � 2.00
<br /> Total Permit Fee $
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<br /> If above does noT apply;follow guidelines below:
<br /> l. COIYTRACT PR[CE " is 1.25%of contract price with s(Minimum�ee of$50.00)
<br /> /�"�,r� X.a�zs� l�7�5"�—
<br /> (contrect pnee) (minimum$50.00)
<br /> 2. STATE_ URCHARGE
<br /> �c,���•� x.0005 $ ��
<br /> (canvac[price)
<br /> 3. POSTACyE&HANDLING(OnI�on Mail-Cn Applications) $ 2.00
<br /> 4. TOTAL PERMiT FEE(Add�,ines I-3 Above) $ �,O�+'`�
<br /> ■ " CONTKAC7' pRICE or JOB COST rneans the actual or estimated doltar amount charged far the
<br /> permitted work includin�materials,labow,profic,and other fixed eosts. It is the amount to be char�ed
<br /> to the customer for the work done. Cf an�material,equipment, labor or installations are furnished by
<br /> the owner,tenant or any other party, the reasonable market value of such items must be added to the
<br /> estimaced cost or eontraet price for permit fee purposes. In the evenC that there is a dispute on the
<br /> amount of the job cost, the City may requesC the subroission af a signed copy of the actual contract.
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<br /> The undersigned hereb� applies to the City for issuance of a MeChanical Permit, agrees to do all
<br /> work in strict accordance with the ordinances of the City and the regulations of the State of
<br /> Minnesota, and certifres that all statements rnade on this application are complete, true and
<br /> correct.
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<br /> Applicant s Signature• ����
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