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,081a4/2011 14:e1 7637177267 CONDOR PAGE 01/03
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<br /> a Yes,this section applics
<br /> The replacement of a Residential fixture oLppliatL�thaL'meets all thrce of thc 1'ollowing requirements:
<br /> 1, es n t cequire modif cation to electrical or gas serviee.
<br /> 2. Has a total co�of�500.00 or less;,e�cludina the cost of the fixriiro or appliance: and
<br /> 3, Is improved,inse�lled or replaced by thc homeowner or licensed contraetor.
<br /> Skip nezt sectian,if this applies; Cost of Pcrmit ���0
<br /> Statc Surcharge $ S,OU
<br /> Mail-In Fce(1f Applicablc) R 2.00
<br /> Total Permit Fee S
<br /> �k�'�thtj'q.,'+�����`��'�� f�i`! I
<br /> If obove does not apply;follow guidcl.ines bclow:
<br /> �, c'9NT CT PRiCE '"is 1 ZS%of conttaet price with a(Minimum Fee of 550.00)
<br /> �a CDD� ' x.0125$
<br /> (contrnct pricc) (minlmam SS0.00)
<br /> Z. STATE SURCHARGT
<br /> ' x.00OS $ _
<br /> (c�nct�ct pt���)
<br /> 3. POSTAG�&HANDLING(Only on Mail-In Applica.tions) $ Z.0�1
<br /> 4. TOThI�PERMI.T FEE(Add L'tncs 1-3 Above) $
<br /> ■ "` C�NTRACT PRICE or 70B COST mcans the a.etual or eseimated dollar amount charged for the
<br /> permittccl work incl.uding ma�erials,labar,pro�it,and othet fxed costs. It is l:be amot�nt to bc charged
<br /> to tbe customer for thc work donc. If any material, cquipment, labor or insta3latio.ns are fumished by
<br /> the owner,tenant or any other party,tk�e reasonable market valnc o:P such items must be added.tq thc
<br /> estimated oose or contract price :Eot�ermit fee purposes. In tl7e event t,hat there is a dispute an the
<br /> amount of the job cosl, the City may request the submi�sion of a signed.copy of che actual contraet.
<br /> � , ,,' � ��
<br /> The undersigned.hereby appl.i.es to the City for issuance of a Mechanical Penrit, agrees to do all
<br /> work in strict accordance wich the or�clinances of the City and the regulations of the Sta.te oi'
<br /> Minnesota, and ceztiftes tl�at all statennenes made on this application are complete, true flnd
<br /> correct.
<br /> Applieant's Signature. Date: U � �I
<br /> 'x._�� .. ,' aw�9wlx, �Y,'o' ,�.i , 9
<br /> 3
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