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, � � � <br /> L: r'� _ •r <br /> Y � y _ ��� � <br /> ❑ Yes,this sectlon spplies <br /> The replacement of a Rcside�ntiai fxNre or applianoe that meets ali three of thc followin�reqniraments: <br /> 1. iaoes not roquire modificxtion to eleclrical or gas service. � <br /> 2. Has a total cost of 5500.00 or less;excla ' thc cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homoowner or licensed co�actot: <br /> Slcip ntzt section,if tbis applles, Cost of Pernlit $ 15•00 <br /> State Su�charge $ .50 <br /> Mail-In Fee(If Applicablc) $ 2.00 <br /> Toial Permit�ec S <br /> �s <br /> � � Y � ��.G.l' , � <br /> If above does not apply;follow guidelines below: ' <br /> 1. CONTRAGT PR�G'� �is 1.25%of comract price with a(Minimum Fee of 550.00) <br /> 5150 X.oias s (a�k ,3�► . <br /> (����) cm��m sso,00� <br /> 2• S7'A7'L SU�tC�ARGE **Add the State Bldg Code Div.Surohsrgc(Mlnimom Fce of 5.50) <br /> . 5� 5o x.0�5 $ a , �� <br /> . c�a�� c��a .so> <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ �,p0 <br /> 4. TOTAL PERMI'T FEE(Add Lines I-3 Above) $ ���y <br /> ■ s CONTRACT P1tYCE ar 10B COST means the ach�al or eszimated dollar amo�mt charged for th� <br /> permitted work iacluding maztrials,Iabor,Profit,and ad�er fixed costs. Ft is the amount to be chac�ed <br /> to the a�stomer for tfte work done. If any material,equipmeirt, labor or installations are furnis�ed by <br /> . tt►e owner,tenant or any other party,the reasonable market value of such items must be added w the <br /> estimacod cost or cotcaact price for pennit fee purposas. ln thc eve�t that theee is a dispu[e on the <br /> amo�mt of the job cost,the City may rcquest the submission of a signed vopy of the actual contract, <br /> ■ **The STATE SIJRC.HARGE is.0005 of the�uilding Departrnem at(9S2)24911600 fot�e price. <br /> The undersigned heneby applies co tlne Ciry for issuance of a Mochanical Permit� agrees to do all <br /> work in strict accordsnce with the ordina�n,ces o;f the Ciry and the regulations of the S�ate of <br /> Minnesota, and certifies that all statemqrts made on this applie,ation are comptette, true a.nd <br /> correct. � ; <br /> ApplicanYs Signattae: ��: \\—�---Q� <br /> �e ■ �- ,�p!�� ����`� <br /> ...._ �,�.+��� � <br /> 3 <br /> L00/ �00'd 69Lfi# �HI'I00� 9 �JHIZt1�H 2i�ZQIiI '3'M Z6Z8LZ8ZT9 SS�BZ 600Z £0/ZZ <br />