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61107/2013 16:39 7637177207 CONDOR PAGE 04/05
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<br /> ❑ Yes,this sectior�applies
<br /> Thc rcplacement of a Residcntia] fixture�r�Dpliattcc that meets all three of the following requirements;
<br /> 1. �oes not re ire modification co electrical or gas service,
<br /> 2, Has a t ta1 st'of$500.00 or less; c u.din the �ost of the.fixture or appliance:and
<br /> 3_ Iy improve installed or repl&ced,by the homeowner or liaensed contractor,
<br /> Skip ncxt s tion,if this applics; Casc of Permit $ 15,00
<br /> Statc 5urcharge $ 5,00
<br /> Mail-Tn ree(IfApplicable) $ 2,00
<br /> Total Permit�'cc $
<br /> �;F�.:a:,,�<r�v�.;, rru�pr.,, ^� ��y; � 1M , y� m nuuu,,:iu,�n.
<br /> ( ,s`:: �� �1T'��M;r�'W.�d�'"� 'y� � °� ��IEJ�` �m��li�,'�'Ti' �!1' I mw."•�
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<br /> if abovc does not apply;f llow�uidelines below:
<br /> l. CONT PWCE "' is 1.25"/0 of contract price wich a(M7nimum Fee ot$50,00)
<br /> � ��(o� x ,0125 $ ��e�
<br /> {�nact pncc) (m�llimum SSD.DO)
<br /> Z. STATE • RGE
<br /> x .0005 $ A ��
<br /> (contract pricc) ' ,r
<br /> /
<br /> 3, POSThGG& ANDLTNG(Only on Mail-ln Applications) $ 2,�
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<br /> 4. TOTAL PE IT FEE(Add Linea 1-3 Abovc) $ �0�� �
<br /> ■ " CONTRACT PRi or .TOH COST rneans the actua] or esttma.l'cd dollar amounL' charged for the
<br /> permittcd work inclu �ng materials, labor,profit,and oTher fxed costs, (i iS Che amount tq be ch�rged
<br /> to the cuscumer for t worly donc, if any mareTial, equipment, lmbor or installaiions are furnished by
<br /> the owner, tenant or y other parry, chc reasonable markct value of such items must be Addcd to the
<br /> estimated cost or co oct pricc for permic fee purpose5. Tn thc event that there is a dispute on che
<br /> amount of the job co t,the Ciry may request the submission of a eigned copy of the ACtusl contract.
<br /> �
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<br /> � �I.y�;" �.�?d��iiA�rv�i .N�M1ay
<br /> Tl�e undersigned hereb applies to the City for issuance af a Meehanical Permit, agrees to do a.l.l
<br /> work in stri.et accordance witll the ordinances of rhe City and ehe regulations o� the State of
<br /> Minnesota, and certifi ' that alJ. stt�ccments made on this applicat.'rvn are complete, true and
<br /> correct, �
<br /> �pplica.nYs Signature; T�ate: �"7'� � �}
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