Laserfiche WebLink
� <br /> � �� ?�'RM1-1 FEF �.�13 Cl'1-�I I(3'�t�) ---------- i <br /> �AS���U O�F 20U2 S i ��'� 1 �i��I IJ�; ! <br /> ❑ Yes,this sectio�:applies <br /> '[�he replacement of a Residential fixture or appliance that meets all three ofthe following requirements: <br /> I. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;exciudine the eost of the fixture or appliance: and <br /> 3. Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Ship next section,if this applies; Cost of Permit $ 15.00 <br /> State Sur-charge $ 1.00 <br /> Mail-In Fee(If Applicable) $. 2.00 <br /> Total Permit Fee $ <br /> � �E�°���.��,���'��a�(s>-=�ass ov�x�soo:.�t� �i; �� � <br /> If above does not apply;foilow guidelines below: <br /> 1. CO':YTRACT PRICE * is 1.2�%�cf contract price with a(Minimum Fee of 550.00) <br /> � � x.0125 $ � � �U <br /> conunct pnce) � (minimum SSOAO) <br /> 2. STATE SURCHARGE � <br /> � DC�c.�.�v x .0005 $_.---" s � <br /> — -t-------- <br /> �c<mtract pnce) <br /> 3. POSTAGE& HANDLING(Only on Mail-In Applicationsj $ 2.00 _ <br /> � �V <br /> a. TOTAL PERMIT P'EE(Add Lines 1-3 Above) $__ J��� � <br /> ■ * CON'TRACT PRICE or JOB COST means the acttial or estimated dollar amount charged for the <br /> permitted work including matPrials, labor,profit, and other fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material, equipmert, labor or installation-s are furnished by <br /> the owner, tenant or any other party, the reasonable market value of such items must be a�ded to the <br /> estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the <br /> amount of the job cost, the City may request the submission of a signed copy of the actual conkract. <br /> ;� ��MECHANIC�i, PERMIT�''P�.iC:�T1C)N t����M�;I�1T ---_� <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies thal all statements made on this application are complete, true and <br /> correct. <br /> , <br /> Applicant's Signature: _ _____ I)ate: _�� �� _ <br /> 3 <br />