2011-00304 - mechanical - Laserfiche WebLink

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y • ❑ Yes,this section applies . The replacement of a Residential fi ture or a liance that meets all three of the following requirements: 1. Does not require mod fication to electrical or gas service. 2. Has a total cost of$5 0.00 or less;excludine the cost of the fixture or appliance:and 3. Is improved,installed or replaced by the homeowner or licensed contractor. Skip next section,if t}�is applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) . $ 2.00 Total Permit Fee $ If above does not apply;follow gui elines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum�ee of$50.00) 38,640.00 X.o12s$ 483.00 ! (contract price) . (minimum$50.00) 2. STATE SURCHARGE 38,640.�� 19.32 x.0005 $ (contract price) 3. POSTAGE&HANDLI�IG(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $5�2.32 ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollaf amount charged for the permitted work including mater�als,labor,profit,and other fixed costs. It is the amount to be charged to the customer for the work done. If any material, equipment, labor or installations aze furnished by the owner,tenant or any other party,the reasonable market value of such items must be added to the estimated cost or contract price�for permit fee purposes. In the event that there is a dispute on the amount of the job cost, the Cityr may request the submission of a signed copy of the actual contract. The undersigned hereby applies t the City for issuance of a Mechanical Permit, agrees to do all work in strict accordance with t e ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements made on this application are complete, true and correct. ApplicanYs Signature: Date: O4/O5/� � e �I; ��I �i��y � ��a��! �a - 3