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Microsoft Word-Mechanical Permit-Updated.dac-Mechanical Per.._ http://www.ci.orono.mn.us/verticaUSites!{CBFC8FAF-C313-4854A2...
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<br /> ❑ Y�,this s�tion applies
<br /> The r�placem�t of a$es�d�+tial fixt�ue or au��a�,ce tl�at meets all three of the follovvi�ag requirements:
<br /> 1. �g,�require modif�catioa to electrical or�ag s�vice.
<br /> 2. Has a o c t of$5�.00 or less;exc�udin�the caet of the Sxtu�re ar appliance:and
<br /> 3. Is improved,installed or replaced by the homeowner or license3 contractor.
<br /> Skip next sec#ian,if this applies: Cost of Permit $ 15•W
<br /> State Sw�charge S 5.00
<br /> Mail-In F�(If Applicable) � z.00
<br /> Total Permit Fee �
<br /> ,,. s���".,a��:�z�;h,, �:��_::
<br /> pB ���: �`�1C�N 5 —7t7BS+C?�TER$S+�O:C�+4',.:.�;a��,�;;e;.�,ke�����=3>����..,
<br /> If above daes uot apply;follow guideliaes below:
<br /> i. �ONTRA►,CT PRICE �'is 1.25°la of contract price with a(Minlmnm Fee af$50.00)
<br /> C� � �d $.012S$
<br /> �ona�t imce) (minimum Sso.�
<br /> 2. STATE SURCHARGE
<br /> x.0005 $
<br /> (��+ce7
<br /> 3. FOSTAGE&HANDLING(Only on Mail-In Applications) � Z•00
<br /> 4. TOTAI.PERMIT FEE(Add Lines 1-3 Atmve) �
<br /> + CONTRACT PRICE or JOB CO3T ra�ans tlze actual or e.stimatefl dollar amaamt cl�ed for t&e
<br /> germitted work i�ludiupt materials,latmr,profrt,aad oth�fixed costs. It is tlte amo�m.t to be char�ed
<br /> W the custamer for the work done. If any material,equipment,latmr or iustallations are fwnished bY
<br /> the owaer,teneat or any other party,�e reasonable market value of such items must be added to the
<br /> estimat�cast or can4ract grice for permit fee purposes. In the ev�ent that there is a dispute an the
<br /> amount of the job cost,the City may request die submission of a signed copy of the actual contract.
<br /> ;n.;;t�;� ��+��C�11'�CAL:g��Mt.T'AP�?'i:��'���}'��
<br /> The tmdersigned hereby �lies tn the City for issu�e nf a Mech�iral Pe�nit, a�rees to d��11
<br /> wark in strict accord�ce with the ordinances of the City auci the regulatians of the State of
<br /> Minnesata, and certifies that all statemen made on tbis applicatian are complete, true and
<br /> cotrect.
<br /> A hcanYs Si Date: J ' a4�l/
<br /> PP g�t�e:
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<br /> 3 of 3 3/21/2013 9:33 Al�
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