|
, ,Og-11—'14 16:31 FROM— T-840 P0003/0047 F-932
<br /> �
<br /> 6
<br /> --�- - z �—'r '_'�'��-}—� �"
<br /> ,V� Y.y� �y �{'.)� � 'q 'r 61:'S�R���S��p
<br /> `{''�°'V���}k"b���, k"''4'L�,�.,k.}c�Z °�k'Nry� �'2, Lf'�'9� .��'4i a}�� � 1'��tk �y���� �
<br /> ru��§�7;fi+'�������� �n'af�';��������'(~� j�y� rM ^� ^Y�� � � ����„ A `�f � �'
<br /> s n �- i , Fj 1 1 �4�47��..C?� �� �(Y �'� � q
<br /> n L',�N ,! �c, 4t > �,,_ � > . f�y �," .� .;,.,r�.�, k{,�,r: ti�, `�.�t� `�
<br /> [] Ycs,chis section applics
<br /> T'hc replaeement of a Residential fixture or a li� anc�that mects all three of khe following requirements: �
<br /> !
<br /> ]. Does not require�3�odifiea[ion to eiectrical or gas service.'
<br /> 2. Has a�gta!cost of$500.00 or less;exeludin the cost of tiic fixture or applianee:and ;
<br /> 3. Is improved,installed or replaced by t��e homeowner or licensed contraetor. a
<br /> 5kip next section,ifthis applies; Cost of permit $ 15A0 �
<br /> State Surcl�az�gc $ SA(1 °
<br /> Mail-in Fcc(1f Applicable) $ ?.�� �
<br /> 1'otal permit Fee $ �
<br /> i
<br /> �„yy. '` �rM � � ` �.�r�r�'�`'�`� �4".l .R'.✓.67�"",�»�� .n � 5-� �+ A�
<br /> h .g��P.,�B�.��?���l ,���4�� c.,�,�, . '4� . ...�_ `/. r�.� .�. '.�,�. A'N�r� i
<br /> _ �
<br /> �
<br /> Tf abovc does not apply;follow guidelines bclo�y:
<br /> 1, CONTRACT P�C�, * is 1.25%of contract price wifh a(Minimun�Fee of�SU.00)
<br /> ��tU�� x.0125� �,j �y
<br /> contract price) (minimum$50.1}0)
<br /> 2. STAT�S�YiCYiARGE ,n`1 '��j
<br /> ����1 V�� a.aoos $ � �
<br /> (contr�C[priCe) f
<br /> 3. POSTAC�E&HANDLING(Only on Mail-In Applicatio�ts) $ �^`�� �
<br /> f
<br /> 4, TOTAL PERM�7'FF:E(Add Lines 1-3 Abovc) $ �1 ` '}"� i
<br /> ■ * CONTTtACT P�2.CCE or JOB COST means the actual or estimatcd dollar amount charged for the �
<br /> permitted work including materials,labor,proCit, and other fixed costs. It is t}te amount to be eharged �
<br /> to the customcr{'or the work donc. If any material, equipmenC,labor or installations are furnished by t
<br /> 4
<br /> the owncr,tenant or any othcr party,the reasonablc market value of such itrms must be added to the �
<br /> estimqred cost. or contract price for I}ermit fec purposes. Tn the event that there is a dispute on the �
<br /> �
<br /> amount of the job cost, the City may request the submission of a signcd copy of the actual contraet. �
<br /> i
<br /> 'R.u��nvP.u.Y.,.A)��'S.W�� !Tf ��,,, S�Ju4.t ��t� \M- S���1'��S� . Y � n� S ,FT�1V' '8. ' �? '� � - II� I
<br /> The t�ndersignec!hereby applies t� [he City for issuancc of a Mech�nical Pem,it, agrees to do all
<br /> work in str�ict accordanee with the ordinanees of the Cit� and the regulations vf the St�te of
<br /> Minnesota, and ceitifies that �II statements macie on this applieatior� are complete, irue and
<br /> correct.
<br /> I �� �% ' ��� /
<br /> Applicant's Signature: ���' T _ nate:�I �
<br /> 3
<br />
|