2010-00642 - mechanical - Laserfiche WebLink

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� Yes,this secrion applies The replacement of a Residential fixture or a�pliance that eets all three of the following requirements: 1. D es not require modification to electrical or as service. 2. H�s a total cost of$500.00 or less;excludine e cost of the fixture or appliance:and 3. Is improved,installed or replaced by the hom wner or licensed contractor. Skip next section,if this applies; Cost f Permit $ 15.00 State urchazge $ 5.00 Mail- Fee(If Applicable) $ 2.00 Total ermit Fee $ If above does not apply;follow guidelines below: 1. C�NTRACT PRICE *is 1.25%of contract rice with a(Minimum Fee of$50.00) �� - � X.a�zs$ -a �- �onva�c ce, �minim,�m sso.00, 2. ST�ITE SURCHARGE **Add the State Bl Code Div.Surcharge(Minimum Fee of 55.00) x.0005 $ �' � v (contract ce) (minimum a 5.00) 3. POSTAGE&HANDLING(Only on Mail-In A lications) $ 2.00 4. TO'�'AL PERMIT FEE(Add Lines 1-3 Above $ ��''�� ■ * COIV'TRAICT PRICE or JOB COST means the ac 1 or estimated dollaz amount charged for the permitted wurk including materials,labor,profit,and o er fixed costs. It is the amount to be charged to the customer for the work done. If any material,eq ipment,labor or installations aze fiunished by the owner,tenant or any other party,the reasonable m et value of such items must be added to the estimated cost or contract price for permit fee purp�s . In the event that there is a dispute on the amount of t�e job cost, the City may request the su ssion of a signed copy of the actual conh�act. ■ **The STA�'E SURCHARGE is.0005 times the Con t Price or a minimum of$5.00. ! The undersignqd hereby applies to the City for issuan of a Mechanical Pernut, agrees to do all work in strict �ccordance with the ordinances of the City and the regulations of the State of Minnesota, an� certifies that all statements made o this application are complete, true and correct. Applicant's Sigpa e: Date: ��G��G� ,:''' � 3