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APR/14/2010/WED 11 : 03 AM CO�PO�ATE MECHANICAL FAX No. 7635333464 P. 004 <br /> . . � . <br /> , <br /> . � . � . <br /> � � ❑ Yes,�is section applies . . � � <br /> The repIacemeat of a Rcsidcntial fixture or appliance that meets all tluee of thc following requirements: <br /> 1. Doas not requixe modificaDo�,to elec�¢lical ox gas service. , <br /> �. Has a tota cost of 5500.00 or less;excl " the cost of the fixtur�or appliancc:and ' <br /> 3. Is�pxavcd,i�uatallcd o►c rcplaccd by#lac}�oza�wmc�c or iU'oc�scd combcnctoz. • <br /> . , Skip next secuou,if shis applies; Cost of Peamit $ 15.00' <br /> � . State 3urcharge . $ .50 <br /> . MaiI-In Fee(If A�plicable) � $ 2.00 <br /> ' � Total Permlt Fa S <br /> If above does not app�y:follow�tuidelines below: � , . � <br /> �. CONTRACT PRICE *is 1.25%o�contract p�ice with a(Miaimum Fee of$50.Op) . <br /> 6 � � �.ox2s$� . �'s`-�. 3 �' . <br /> (conaacs price) • (minimum sso.00) . <br /> �, STAT&SURC�ATLGE �"�Add the State�1dg Code J�irv.Surc,harge(Minin.ym Fee of S50) <br /> -� � x�.000s s � r 3� � .� . <br /> , . , .(conuact prica) (minimum S .50) . <br /> . 3: POSTAGE&HANDLING(Only oa Mail-In Applicatious) � • � 2.00 ' . <br /> , � , � . . <br /> • 4. TOTAL PERMIT FEE(Add L"uses 1-3 Abov�) •$ . <br /> ■ ; CONT'RACT PRICE or J08 CQST meaas the a�ctual or estimated dollar amolmt aharged for the <br /> pex,mitteal wo�rk imc�uc�uue�aaaoerials,�labrnr,Pxo�tt,azad ott►e�'�ed costs. It iis the aa�ount�o be'chaxSad <br /> .• to the custoiner fo�r tk�e woxk done_ Tf a�v baate�aa�, e4wiDuae�at,Labor ox iwstallabio�as are funnuisbied by . <br /> ' the owner,tenant or,any other party,the reasonablo markct valuo of such items must bt added to the � <br /> estimated cosc or conuact price�or pem�uit fee puxposes. In,the event tY�at;there is a d�spute on t�e <br /> �mouuat of tlae job cost,tb�e City u�ay request the submission'o�a�tgqed copy af tbe actual contract. <br /> • . ■ ""The STA?E SURCHARCrB is.0003 o�'ttle Suildfng De�arCmertt at('95Z�z49-4600 tbr the�[ice. • • ' <br /> The undersi�ned hereby applies�to the City for issuance of a Mechanibai Permit agsees to do all <br /> � work in strict accordance with the ordinances of the City aad the re�lations of the State of <br /> Minnes�ta, and certifies that all statements made on this�application are complete, true and � <br /> correct. � , <br /> � Applicant's Si�ature: ' Date: �/f.���� <br /> � . . <br /> . , g , . _ . <br />