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09/08/2011 11:15 7637540132 RICCAR PAGE 03 <br /> • <br /> I�\4'•� V r_ 2 f.i ry r.il '\ 1 <br /> {, as r �r��,a r1� d 4 r� ice, r.fi pt s <br /> la ti , 7 n F Y"'_' 4i3T'�'t/1 -='�.�v,. �t 3�.'r� r��7'ri 'yv� "��.,. ... <br /> rn M1T �� P ,' aj ':'!aY •fit" ` <br /> 0 Yes,this <br /> section applies <br /> The replacement of a Residential fixtue 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 total cosi of$500.00 or less;et_ujjsjing the cost of the fixture or appliance: and <br /> 3. Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit <br /> S 1$.QO <br /> State Surcharge 5 5.00 <br /> Totalrm tIfApp]icable) $��, '_ <br /> Total Permit Fee <br /> 'I' �►;f' � 1 �,m'hl 0. Mytwr yi` <br /> If above does not apply;follow guidelines below: <br /> I. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> x.0125 $ <br /> (contract price) (minimum 550.00) <br /> 2. STATt SURCHARGE <br /> x.0005 $ <br /> (contact price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2. <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <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 /> '`a. .I' Fp. :Vm ;:'�, riakt ll6'r'Z;'-,'"1 <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 /> Applicant's Signatu ` i���/ i Date: <br /> !— /1' <br /> 3 <br />