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07-16-'15 15:17 FROM- T-062 P0003/0004 F-266
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<br /> ❑ 'Yes,this section applies
<br /> The repl&ctment of s Residential fixiUre or appliance that meCts�Il thrce of the following r�quitements:
<br /> 1, Does not require modi�cation to electrical or gas service. '
<br /> 2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance:and '
<br /> 3. Is improvtd,installed or replaced by tho homcowncr or liconsed conCr&Ctor.
<br /> Skip next section,if this applies; Cost of Permit � 15.00
<br /> Stafe Surcharge $ 5.00
<br /> Mail-In Foo(]f Applicablt) $ 2.00 '
<br /> '1'otal Permit�'ee $
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<br /> If above docs not apply;follow guidtlints below� '
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<br /> 1. CONTRACT PKXC� * is 1.25%of contract price with a(Minimum Fee oi 550.00)
<br /> 3,4$5.00 �'�:o.1�2s;,$;::;::=;,`'-�k:;;5.0,:QQ;;�:�»�;;:�'_�;�°::;', :
<br /> if�►S.�s�prac�c�,' . ;(mlit�xf�:S :J44.`. '
<br /> 2, STAT�SY)R(:HARG�
<br /> 3 4$5.0o X;oaos':�;:$� 1.74
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<br /> 3. POSTAGE&HANDLTNG(pnly on Mail-In Applications) `$j �2�;00;>;��;���'�''�`!���;
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<br /> 4. TOTAX.P�RM�T�IEIE Add T.ines l-3 Above `�:.'` ` •�.3:74'';:�i,;�;';: �``�`� '
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<br /> ■ ' CONTRACT PRICE or JOB COST means the actual or estimated dollar amount char�ed for the
<br /> permitted work including rnatzrials,labor,profit,and olher fixed costs. It is the amount to be charged
<br /> to the customer for the work done. Cf any material,equipment, labor or installations arc furnished by ;
<br /> thc owner,tenant ar any other parry,the reasonable market value of such items must be addcd to thc ;
<br /> estimated cost or contracC price for permit fcc purposes. Cn the event that therz is a dispute on the
<br /> amount of the job cost,the Cicy may requesC thc submission of a signed copy of the actual contract. �
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<br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to dp all '
<br /> work in strict accordance with the ordinances of the City and the regulations of the Stata af
<br /> Minnesota, and certiftes that all statements made on this application are complete, true and ',
<br /> correct, j
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<br /> Applicant's Signature: �Aates-%` 7/16/15 �
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