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05/30/2013 12:28 7637177267 CONDOR PAGE 03/63 <br /> , . . <br /> .��'�iA' <br /> „�r��...� ;�.,.,.. _.� <br /> 0 Yes,tt►is section a{�plies <br /> The replacemeot of a Resid 'a �ixturc o liancc that meets all three of thc following roquirements, <br /> 1. Do..cs11�t require modification to elecaical or gas service, <br /> 2, kTas a totaf cost of$540.00 or less;excludi�the cost of t�e fixt�u�c or applianoc:and <br /> 3. Is improved.,installed or replaced by the hom�w�ter or liconsed contractor. <br /> Skip next section,if this 8�pplies; Cost of PCrtnit $ 15.00 <br /> State Surcharge S 5,49 <br /> Mail-In Fec(If A,pplicablc) $�� <br /> Total Permit Fee S <br /> If abpve does not apply;fol.law guidclines below; <br /> l. CQiVTRACT��,� *is 1.25%of wntra�ct price with a(Minimum Fee o�$50.00) <br /> ��o x.o�.zs� 4 -o O <br /> 1"'-��c�r;x) _ iro:��mam sio.00y <br /> 2_ �'TATE S.LIRCFIARGE <br /> l ,S(!�� x.D005 S . r,��,,,,,_ <br /> cpntract pricc) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ �,4(� <br /> 4, 7'O�'AL�ERM1T FEE(Add Lines i-3 Above) S_`7�•�� <br /> � • CONTRA,C7'YRI.CE or JOB COST megns the actual or estimated dollar amount charged fot the <br /> per�itted work inctuding lnmte�ials,laboi,proFi.t,and other fi7ced costs. It is tlae amount td be eharged <br /> to the cvstamcr for Lhe work donc. X�eny matorial,equipment,]gbor o1'installations are fumished by <br /> Che owner,tenant or any other party,thc t'easonable market�ttlue of such items Irtlust be addcd to the <br /> estirnated cost or contract priee fofr perniit fee purposee. in tha evcnt that there is a di.apute on the <br /> 8tl�ount�f the job cost,thC City may requCst the submissian of a 5'tgrted copy of the actual conixaCt. <br /> The undersigited hereby applies to the City for issuance of a Mechanica� Permit, agrees to do al.l <br /> work in strict accordance with. the ordinances o£the City and the regulations of the State of <br /> Minnesota, and certifics that all statements mad.e on, this applic�tion are complete, true ar�d <br /> correc�. <br /> Applicant's Signature: , � Date:.,�,Zs.S...��L''� <br /> 3 <br />