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.r du av�Y � i•�:am ri�m.'�iii �- vrtv�� 7Yp144G4U�C ��COf Y UU4/�UQ ''J�� <br /> � �RY <br /> p�RMIT_FEE CAX�C'tiLA�rTON(s� <br /> 2001 St�te Statute (� Yes Tbis Sectiou Applies <br /> The replacement uf a Rcsident;al fixture� li,p�ance that meets ail t}uee ef t1,e followin�xequirements: <br /> 1 j Dges not raquire modification to elcctrical or gas sernce, <br /> 2j Has a t�tal cost of 5500.00 or less; excludir, thr c�st afthe fi:ccure or appliance; <br /> and <br /> 3 j Is impr�aved, installed o:replaced by the homecw�er ar lrcensed contrac.or. <br /> �kip next section; ��ost of Permit $ 1S 00 <br /> State Surchr��e � .50 <br /> 'r1ai1-Ln Fae $ 1.50 <br /> 1�'above doas not apply,zallow guidelines belo���� <br /> l. Cuntract�rsce� is .0125°/u Of,JJb 4N1t:1 a M10S7t1U7t1�cc of{��5.00) <br /> ��� 5:.; <br /> 3j noo. - x .c��5 g 3 7 -�-- <br /> (cor.nact gncc) (rrur.;mum 335.�) <br /> 2. StAte Surr�arxe. "�w Adc�th� Statc Building Cod�pi�7sio-�a i�iinfraium Fee of $ .50 <br /> �� � S� <br /> ._�d°c'' x ,�4J5 $ ' <br /> (concract pricr) (minimurr.S .SU) <br /> 3. Posta��and Haradiita�(O1rly n�nil-i�r applicauarrs) $ 3.SC! _. <br /> �. TOTAL pEIL�iIT FEE (Add 1�nes 1-3 above) $ 7��_ S� <br /> 'CUV'1 K.1C'Y'P12IC•E ur)QS C4$T r.uar.s th:ac:ual or tst;matcd doliar atr.ount chargcd fcr the rcnni.trd work mcluding <br /> mAtcti&IS,labor,profit,and othtr fix�d�oscs It is the nmount to be charKed,e the customer for the�,vork done.Tf z�iy matcrisl, <br /> equipmenc,!ab•�r,or ir,stall�ticn is furnished by the owr.er,ttnant o;anW orht:party tht reason�ble ma;ket value of iuch iams <br /> rr,usi be ad4rri to�t!c csrirutted cust or corcract�r,ec f'or perm�t fcc puryases.In th�evCr.�that there is a dispute on the a:ro4nt of <br /> tF:c,jub�ost,thC Ciry may Tequcst C?-e submissi�r.af 2 si,�ned cupy of the actue!conttact. <br /> •"'Fhe STATE SURCHI�RGE is ,0005 Cf che contrac.�t price under S 1,�7i1G,G00 or 5.50-whict�e�er is�reater. For valwiions ovc,- <br /> bi,400,U00 call the llep�rtm�ni oi Inspccuona!Srrvices icr the prict. <br /> T'he undersigned he�eby Applies to the Ciry for issutnc:of s Mechanic2l Permic,agrees to do aIl K�ork in srri;.t accordancc�tirt5 <br /> thc o�d�nitices of t�e Ciry ar.d ttir re�ulauons of the Minr:esota State Bailding Code,and cenifies that a1l statemer�ts r.�ade on this <br /> applicacion a-r complctc,m,r and corcecc. <br /> /P A rr1 /���-�it� r c:.-E f �`�"/� _ <br /> Applicanc's Sisrnature: � � _.��.�!%�' Date: fI— 3 v .�f <br /> Apprc�v�d B�.., � � � llate: .____�.........._._._.�. <br /> 3 <br />