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01iO3i2011 11:27 DITTER INC � 9522494616 N0.238 D04 <br /> , , ,. <br /> � .:; . ,, .,,. . .. . . .. .. . .. . <br /> . . . . .. <br /> � � � .: P�R1�1�T�>�����.,,�u.AT[O'�1(�), <br /> �AAS,Rl��'�:FF�2QR2�`��'ATE,�T��`rI;J.E ; � <br /> � V'es,this secuon applies <br /> 'the replacement of e Residcnti�l f xturc or appliance th�t meets�II three of ihe foUowing requirements: <br /> 1 1. .Dues not require modification to electric�l or gAs scrvioc. <br /> 2. Hes a ta cost of$500.00 or Icss;excludin the cost of the fixture or applianco:and <br /> 3, Is improved,installod or replaeed by the homeowner or licensed co�tractor. <br /> Skip�cxt 3Cction,ifthis spplieS; �ost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> I Mail-In Fee(IfApplicable) $ a.ao <br /> Tptal Pecmit Fee $ <br /> � � l��t?F� '`:1:�'::�?���� �S�ALCUS:�AT101�,5��-JOB�a 0�1Ebt �qQ:QO <br /> rf above does not apply;follow guidelines below: <br /> 1. CON�'�4CT PRrC� ' is 1.2�0 of contrect price wirh s(Minirnum�ee of 550.00) <br /> _�� x.0125$ ) �� � <br /> (contract�rice) (minimum SSP,cK1) <br /> �. STATE SURCHARC� **Add the S[ate 131dg Code Div.Su�charge(Miaimum�ce oPSi.OU) <br /> x.aoos s �� <br /> (conanM price) �minimum 3 5.00) <br /> 3. PO5T�1G�&HANbLINCr(4nly on Mail-ln Applications) $ ?00 <br /> 4. 'fOTqY.P�R�MY'1'��(Add Lines t-3 Above) $ `��f <br /> • " CONTRACT PRfC� or JOB COST means the actual or estimated dollar �unount charged for the <br /> 1 permirted work includiog materiols, lobor,pro�"it,flnd other fixed eosts. It is the amount[o be charged <br /> to che customer for the work done, lf any materi9l, equipment, labor or installations fue furnished by <br /> �he owner,tenent or any othcr party, the reesonable market value of such items must be added to the <br /> estimated cost ar convacl price for pormic fee purposes, ln tha even� that there is a dispute o�� the <br /> smaunt uf the jab eosl', che City may request the submission of a signed copy of the aetuel contrac[. <br /> � "The STAT&SURCHARGE is.0005 times the Conuact Price or a mini.mum of a5.00. <br /> �1,�����,:��� N��''..'�;'.P�,�RIVf�:�" � �'��'P'f,..iCAT�.C�N:,�GR��MENT <br /> I The un�ersigned hereby applies to the City for issuance of a Mechanic�l Permit, agrees to do all <br /> wo�k in strict accordance with the ordinances oF the Ciry and Che regulations of the State of <br /> Minnesota, a,�d ceirtifies that all statemenu made on this application ar� complete, true and <br /> COr�Cc�. <br /> 1 <br /> Applioant's Sigr►ature: � 13ate: '� f <br /> ........... ... .......::........ <br /> Res�l�`Fi�'i: 3 <br />