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Aug, 27, 2009 12 ; 20PM ASSOCIATED MECHANICAL No, 3379 P. 4 <br /> nS� �i �1 .� ��y k y ,: . � p���� I t �.- . � ,. _�r�F—'.,.,.,"C^' ,�„�,^-„rr^-"-hQ. ,. <br /> M1-`a t f �4 rE �' l � � s � f' � � � <br /> r �-���f>��>�'� �;"� ro�, —'�*.��:.'``�--��"�`�' :,� ,�,t��`�����, w��" ��y��� ,�;a�'�-b�y� � <br /> � � �..,"�.�._..�� �� !�`..�'�`5:�����,�:�"�����.�.��'ad.�`� �-' ��_=,a�3 u��,.,:��;i���d ��� s','�� <br /> @� .��;t34 "������ r 4 u � .t�., ss - <br /> ❑ Yes,this section applics <br /> Thc replacement of a l�esidcntial�xture or�alianco that meets all three o�the followrng requiremcnts: <br /> l. I�oes not require modifieation to elcctrical or gaa ser�vice. <br /> 2. �Tas a total cost of$500.00 or 1ass;excludinQ the eost of the fixture or appliancc:and <br /> 3. rs improved,installed or rcpleced by the homeovvner or licensed eoniraetor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> Statc Surcharge $ .50 <br /> Mail-In Fee(Yf Applicablo) $ 2.00 <br /> Total Permit Fee � <br /> ..-- _ ...-. : --. .. <br /> ir.::: �rv:: � ...:_ -r :::_ —+r• ' <br /> :L- '' ' Y � � . :' a,:: � r._ � ,'. ' _ o:?i'c;r; <br /> 'Slll 'r:'s-.fi - � - � ..=i�oNlbi �`:.Tsl�l:� <br /> Tf abovc does not appl�;follow guidelinea below: <br /> 1. CONTRACT PRXCE *is 1.25%of contrAct price with a(Mlnimum�`ee of�50,00) <br /> 1,300,00 x.0125$ 50.00 <br /> (Conlract pricc) (minimum$50.00) <br /> 2. STATE SURCM�ARCE *"Add the S[ate Bldg Codc Div,Surcharge(Minimum Fee of 5.50) <br /> 1,300.00 x.0005 $ 0.65 <br /> � (contracl pi'Ice) (minimum 5 .50) <br /> 3. POSTACr�&�ANDLING(Only on Mail-In Applications) $ 2,00 <br /> 4. TOTAT.PEIZMIT FEE(Add T.ines 1-3 Above) $ 50.65 <br /> ■ � CONTRACT PRICE or JOB COST mcans the actual or estimated dollar amount charged for the <br /> permitted work including materials,labor,profit,and other fixed costs. Tt is thc amount to be ehargcd <br /> to the cuatomer fbr the work done. If any material,equipmont,labor or installations are fiimishcd by <br /> the owner,tenant or any other party, thc reasonable markct value of auch items must be added to the <br /> cstimated eost or contraet priee for pormit fee purposcs. In the event that there is a disputc on the <br /> amount of the job cost, the City may request the submission of a signed copy of the aetual contract. . <br /> ■ *'"The STATE SUKCHARGE is.0005 of the�uilding Department at(952)249-q600 for the price. <br /> Id k., �_ 4 '� . �� _� .. -� y��� .. . ,_ .' �:' i _r .��;� " <br /> _ <br /> � ,a � � - r � �=::i ��.�-�i�f <br /> : ' - , , �:, -� <br /> �y 6 �I�.;ft�.= `� a i�� � �, � :� �• E .. �� � <br /> The undersigned hereb� applies to the CiCy for issuance of a Mechanical pernut, agrees to do�all <br /> work in striet accordance W✓ith the ordinances of the City and the regulations of the State of <br /> Minnesota, and certif es that all statements rnade on this applicatiom are complete, true and <br /> correct. � <br /> Applrcant's Signature: Date: 08/27/09 <br /> p���i� +i," ���_ ���� ���� aur ,+ <br /> '�aa� {��,i���� Q��������a���"1 <br /> 3 <br />