Laserfiche WebLink
� � , <br /> � ' <br /> ❑ Yes,this section apFlies <br /> The replacement of a Resider_tial fixture or appliance that meets all three of the following requirements: <br /> 1. Does not require modificarion to elechical or gas service. <br /> 2. Has a total cost Df$500.00 or less;excludins the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip next secrion,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> If above does not apply;follo+�guidelines below: <br /> 1. CONTRACT FRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> �' �� ' � Zos , I °� <br /> R.oizs$ i <br /> (con ct price) ( imum$50.00) <br /> 2. STATE SURCHARGE <br /> 4'(� �I C� `�" X.000s $ `����l <br /> (c tract price) <br /> 3. POSTAGE&H�IVDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMrI'FEE(Add Lines 1-3 Above) $ ���S E��' <br /> ■ * CONTRACT PRICE nr JOB COST means the actual or estimated dollar amount charged for the <br /> pertnitted work includin�materials,labor,profit,and other fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material, equipment,labor or installarions are fiunished by <br /> the owner,tenant or any other party,the reasonable market value of such items must be added to the <br /> estimated cost or contra�t price for permit fee purposes. In the event that tfiere is a dispute on the <br /> amount of the job cost,:he City may request the submission of a signed copy of the actual contract. <br /> The undersigned hereby 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 certifies that all statements made on this application are complete, true and <br /> conect. <br /> Applicant's Signature: ( C." Date: �����"� r� <br /> � <br /> 3 <br />