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� � --.. ..._ . _,. . .__.,.., , ,., <br /> �'���'��'�CAY.CU�.ATYOM�BI <br /> 2i}Q� Sc�,,,t t� e ❑ kes Ti�i�Section Apptics <br /> The repiacart�ont of a�t,es�dec��ial �xture or a�ance zlxat raeets sl!tl:rce af the followin�requircrraents: <br /> l) es requi,re maddfl�tiora to el�crrical or�as service. <br /> 2) Hus a,�4,�of$S�C.OQ or tess;excludi�aQ the cosc of rh�ftxture or appliancc: <br /> and <br /> 3} Is improved, i��talled or r�placed by ihe horneawr���or li�er.sed contractnr. <br /> S�Cip ncxt seczian; Cast of Fermit � 1 .Atl <br /> State Surchargc$ .SO <br /> Mail-In Fee $ i.5� <br /> If above do�s not apply, fallaw�ui�eiines below; <br /> X. C�n r ct rice*is .OI?S%�f jqb witka a�num fiec of f�3S.001 <br /> ��r� .�J x.4125 $ �->� � <br /> 1.c:ontract price) (minim�am S3S.00) <br /> 2. State 3urcharge.*�Add d�e State Huilt3ing C�dc Division a�inimam�cc g�( .SO} <br /> ,, i <br /> �=IU�� X .noos � <br /> tcoAtract pfiCe) (,mit��rlluttt� �•SC') <br /> 3. �"ns+tage and Haadlin (Only ma!!in applicRXlnns� $ i.�� <br /> 4. 'I"O'Y'AL PtRMIT FEE(Add linas I-3 abov�} � ��.�� <br /> '"CON'['R.4CT PRICE or 30�COST me.ans th��uctual or rstimatcd dol}ar a,r�auns ct�arged for itte pe�tr;it[rd work including <br /> ma�eriels,latror,profit,and arher frxed casts,Jt is thc amour,t co ae cha�geii ta she austomer gor the work dane_kf a�y marerfai: <br /> �quiprnent,!«bor,or�estallstion is fiarnuhcd ky[he awrter,unant ar�riy otfier party sht re�tsonabJc:maeket ti•alue of such itoms <br /> mu3t bC�dc�od tc�4he ostimateC cost or conU'ac[price fof pCtmic P�t purpo�e�.:n thc rvent that tt�erc is a Qi�p�.tt on tht amount of <br /> Th�}Ob Cos1,1ho Ciry�snay req�est shc submission at s se�noQ�napy of khe aCta4i cdntrYaCc� <br /> ""The STATE SURCHARG�.is•.aQ05 aftttecontract�reec undr�$1,pU0,000 or$.SO.whichever'.s�resxe�,For vAluationv ovrr <br /> $l,040.OQG cali thr D�umnent of Iaspcctionsl Scrvices fax the pricc. <br /> Thc undcrsi�ncd hercby�pplres�a the City!�r is�u�ncc af a A�echanicai P�nnic,agrr,cs�o do a�t work in,rria accordanc�w',ch <br /> tfie ordfnances of thc Giry attd ttt:segulntions of th�Mlnnesai., ^stat�Bnil�ing Ca4e,and e��tias thut a[]statemmts ma�c an,his <br /> aAPlication are cpmp�eto,trua snd carrcc�. <br /> Applicar�t's �ignxtuce•_ 1 )���� � <br /> �"....� Date:���s�s'.Fy'.�._ <br /> ,approved 8�: __ Uaie; <br /> 3 <br />