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06-08-'15 17:31 FROM- T-885 P0003/0004 F-074 <br /> © Yes,this section applies <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. Hasa total cost of$500.00 or less;exclg&g 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,ifthis applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Pee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> 6 �, <br /> �K. <br /> i <br /> If above does not apply;follow guidelines below: <br /> i <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50,00) <br /> 7,865.00 Oil ?` +.''�Nti�1`�`:"-z^a:` <br /> ,(se►ihsc�:....cs; .(ni.:,mum'F" +�a <br /> 2. STATE SURCHARGE <br /> 7,865.00 xr: ogs': g; 3.93 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) i <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) i 'tr1Q'4G2ry ;1t. =� <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 /> .NOW W10,111, <br /> r. ..� ,. :-h1SAtkrti�'.h� ilyiAti�;at, n vd'S4( <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 Signature: <br /> 1 <br /> 3 <br />