Laserfiche WebLink
09—�8—'14 14:45 FROM— T-959 P0003/0004 F-060 <br /> ❑ Yes,this section applies <br /> t <br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a 191la cost of$500.00 or less;excludin the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> i <br /> Skip next section,if this applies; Cost of Permit $ 15.00 i <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> R0 '�/y0�/(4�O(�� R; t. WIN <br /> yyQ '�, <br /> -.V'.6zH!'111�F.� ..��.1. :� .Q4.. .!P. <br /> I <br /> If above does not apply;follow guidelines below: f <br /> 1. CONTRACT PRICE "is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> ( <br /> x.0125$ 5 I ,_T_ <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE 5 C <br /> I X.0005 $ � ► .-."r <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.60 <br /> � <br /> j /q <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ✓� i <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials,labor,profit,and other fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material,equipment, labor or installations are furnished by <br /> the owner,tenant or any other parry,the reasonable market value of such items must be added to the <br /> estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the <br /> amount of the job cost,the City may request the submission of a signed copy of the actual contract. <br /> i <br /> i <br /> I <br /> The undersigned hereby applies to the City for issuance of a Mechanical permit, agrees to do all <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> i <br /> a <br /> Applicant's Signature; � Date: ( � <br /> I <br /> I <br /> 3 <br />