2010-00208 - mechanical - Laserfiche WebLink

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�' � . � . �: �t� ' L : -' 3 f � b . i , "�'� i z-� .t�� �. �l,r� a�� „�}Ct..A a _ „x a?s y.3 ❑ Yes,this section applies The replacement of a Residenrial fixture or appliance that meets all three of fhe following requirements: L Does not require modificarion to electrical or gas service. 2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance: and 3. Is improved,installed or replaced by the homeowner orlicensed conhactor. � Skip next secrion,if this applies; Cost of Pernrit $ 15.00 State Surcharge $. :50 Mail-In Fee(If Applicable) $ : 1.50 Total Permit Fee $ �'�`�`� � _ �E� �` ��:� � �� .�$:�° ' F :� .�'0, �' :� � , , � „ ,...: �, �. , ,. _ . . . . :. , � If above does not apply;.�'ollow guidelines below: , 1. CONTRA�T`PRICE '"is 1:25%of contract price with a(Minimum Fee of$35.00) _ � , , _ , .S"6„�o x.0125$ ` �e+C7'=-�'G� : ' . (contract:price) , , (minimum$35.00) , - < 2. STATE:S.URCHARGE **Add the State Bldg Code Div.Surcharge;(Mirtimum�ee of$.50) S�i.DY�O x_0005 $ _ v�$.f.� : (contract price) (minimum$ .50) : 3. POSTAGE&HANDLING(Only on Mail-In Applications) `.' ` $ 1.50 ' - 4. TOTAL PERMIT FEE(Add Lines 1-3 Abovej $ ��• a� : ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the ' pernutted work including materials,labor,profit, and other fixed costs. It is the amount to be charged to the customer for the work done. If any material, equipment,labor or installations aze furnished by the owner,tenant or any other party, the reasonable market value of such items must be added to the : estimated cost or contract price for pemut fee purposes. In the event that there is a dispute on the : amount of the job cost, the City may request the submission of a signed copy of the actual contract: : ■ -**The STATE SURCHARGE is.OQOS of the Building Depaihnent at(952)249=4600 for the price. , {. , „� . h,�. ..a ' _ � � ; �� ;Y�3� . ._ �' � . . � ":. � ' �� . . �{ . .4. � v ..... .,.. .. � . ' - . «. . .._�. :. .. ..... ,. ..;.,. . ' ' � The undersigned hereby applies to the City for issuance of a Mechanical Permit,agrees to do all work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements .made on this application are complete, true and correct. Applicant's Signature: `�- Date: 'S� d /G7 : � . \ 3 -