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Dac-19-2002 d4:40pm From-CITY OF ORpNO +9522494616 T-656 P.�09/a04 F-680 <br /> . � <br /> PEIt1VIIT FEE CA C?CrY.ATIONSSI <br /> 200� State Ststate []''Y'es Thi�Section Applies <br /> The reptacement of a Resid�tial fixture s�r ag liance that meets all three of the feilowing rec�uirem�nts: <br /> 1) D�o ;�require rnodification ta electrical �r gas service. <br /> 2) T�as a tai cost of$SOU.OU or fess; cl i thc cosc of the fixture or app]ianc�: <br /> and <br /> 3) Ls iaipraved, installed ar replaced bythe homeownet or licensed contra�tor. <br /> Skip next sectian; Cost uf Perntit $ 15.00 <br /> S�ace Surcharge� .50 <br /> Mail-In�ee $ 1.Sd <br /> If above daes not apply,follow guidelines b�low: <br /> 1. Cantraet Price* is .0125% of job with a Minimum Fce of tS35A01 <br /> `� IS,�s'v X.OI25 $ I�13. I� <br /> (con[ract price) (minimujn$33.00j <br /> 2. Stsde Surchur�e.**Add the State Building Code Aivision a Minimnm Fee of(S.50) <br /> �' , <br /> �Sf'�/�� x.d0U5 � �- �Z <br /> (canuact pricc) {minimucn$,SU) <br /> 3.�'osta�e an �Yandlie�(Dnly muil-in a�vplicatio�rs'� $ 1.50 <br /> 4.TOTAY.PEl3A�.'r�'EE{Add lines 1-3 above) $ �OO•�'S <br /> •C�NTltACT PRiCB nr 70B C05T means the ttCtual Ar estimated dollat amouni chargrd tor the permitted work including' <br /> rnstereRls,tabor,profi[,tutd othrr ftxed casts.It is the�Titoun[co be charged w the customer for the work dant.If any matcrial, <br /> equipmtnt,lahor,ar ins[8lladon is furnished by thc otimrr,�hl�rtt or any othrr patly ihe re8sonable msrlcet vdEue r�f Such items <br /> m.ust 6e added m thc estimsuad cost or contract prico for permit fee purposes.In th�evsn[that there is s disputc on she amount of <br /> �ha job cost,�ha Ciry may request the submission of a signcd copy af the actual rnncrac�. <br /> #"The 5'I'ATE SUILCHAItGE is,0045 of thc coau'�ct price nndcr$1,OOU,OOa ar$,50-whichtver is�r'eater.�'or valttarions over <br /> $1,OOU,000 cal!tho Depanment oP[nSpectional SrrviCea fat the price. <br /> 'Y'hc undarsigncd hertby applics ro che City for issu8nca of s Mecfianical Prrmit,a�reGs ro do a11 work in striCs accordance with <br /> ihe ordinances of rhe City�ts�d the rc�ula[ioris of the Minnr3vsa Stase Building Code,�d cer�ifies that$tl st�ttmtets made on this <br /> a}sp)ication arr comple�s,tru�atid correc� <br /> Applicant's Si�amre: Date: `'�6 �'v—� <br /> Approved By: Date: <br /> 3 <br />