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�av-15-2002 '1:30am Frcm-CITY 0� ORONC +9522494516 T-242 P.00?!DC' F-T6t <br /> . • <br /> p�Tt,'VIYT 1�'EE CAY.C�(Tu.AT�42AifSl <br /> 2i40� State Statute 0 Yes Thi�Settiorr Applaes <br /> T'he replacenrent of a Residential fxrure or aQplianc�that rneers alt three of the following requirements: <br /> 1) I7oes not require mod��icailOr��0 eieCt7iCa1 Or gas service. <br /> 2) �Ias$���of$SOC.00 or less;exctudinQ tFre cost of the fixture or appliance; <br /> and <br /> 3) is improve�, installed or replaced k�y#he homeov�mer or licecsed cantractor. <br /> Skip next section; Cost ot Permit $ 1�.00 <br /> State Surcharge$ ,50 <br /> Mail-In Fee $ 1.50 <br /> If above daes not apply, fallor�v guideiines below: <br /> �„ �nntract Price* is .0125% of job with a Mina�num�ee oi fS35.Q01 <br /> _`la0 �;.aizs $ �5Z��`� <br /> �GOT,i�CT QCICC� (minimum 535.+x!) <br /> 2. State Surcharge•**Add tl�e Staie Buildin�Coc.ie Divisio:�a Minimum Fec of_($.�0) <br /> � x .0005 $ �� <br /> (.un act ps:ce) crr.in�mum Q.SC�} <br /> 3. Posia�E and�andling{Only mafl-in applicnti��ns� $ I.�O <br /> 4, 'TUTAI,PERIVIIT FEE (Add lines �-3 a�ovej $ _ <br /> '"C(3:�1TRAC';PRiCE ar 30H�'OST met►ns the actual or rstimsted dollar arnount charged?or Yhe pet�r,i[ted tivork inciuding <br /> materials,fabar,profit,sr►d other fixcd costs.Pt is rlic amount tc be charg�a w zhe cusYomer far the w•ork done.[f any tnacerial, <br /> equipment,Pabor,ar installation'ss fvrnished�y che ow;�er,iPnant��asly otllet peiYcy tt►t rerlqonable market v$lue of such iterns <br /> musB be added to tht estemated cast or oonttact price for petmii fte purposes.:n thc cvrnt ttiat thecc is a disp�tt fle the amoant oF <br /> [R�job cost,lhe Ci:y may request th�submission of a signed capy of the actuG!cOnut�et, <br /> *'Ttrt STATE SU�.Ct�ARG�is.�3pp5 ofthe coniraci pric�unc�eP�1�000,000 or$,SQ-whichever s greaBer.For valuacions ovcr <br /> $l,OQO,OOti ca11 tht D�pars�en:of Inspectioaat Scrviccs far chc pricc. <br /> Thc und;.�°signcd hereby appli�s t�the City For issuancc of a 141cchan�cai Pcrneit,agrees to�o a1t wotk in snicr accardancc�+vitti <br /> the ordinarices of tAc City and th:ctgudntians af tht M;nnrsota Stat�Building Code,�d certr#ies ihAt�tl statcments ma,:c on:his <br /> applica*ion�'�compic:e,:rua and corrcct. <br /> , � <br /> Applicant's Signact�re: I�ate: 5 <SZi <br /> Ap�+roved�y: �.� Uace: � " I`� -`�-�,—. <br /> 3 <br />