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� Jul-it-2Q11 D6:31am From-CITY 4F ORO�p +9522494616 T-Od2 P.003I003 F-tt4
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<br /> ❑ �'es,ihis sertion a�plies
<br /> The rep]acemenr of a Residential�xture or applixncc that meets all tfi�e of the foll�win�r�ttiretnents:
<br /> 1. � o.require moditcataon to electr;cal or gss sErvice.
<br /> :. T�As a WtRI eosr of$SOO.UU)or lass;exciudin�the cast of the fixture or sppLxnce_and
<br /> 3. ls improve�,installed or rcplaced�y the hameow�ner or licensed con�actar.
<br /> Skip next section,if this appties; Cost of permis � t S.Od
<br /> State Surcharge � 5 A)
<br /> Mai1-In Fee(Tf Applicable) $ 2.bt5
<br /> Totat P�rmit�'ee $
<br /> �Fi� �� i�;i w:, � t 'F , �!1 E. '�' ''.�3�'F7�'}�Ittl�.y �� l�:�k��r�o�i•"
<br /> If above dces na�appty;failo�v,�uidelines 1>elow:
<br /> 1. CONTRACT PRl'Ct�: *is 1.25"/0 of contract price with a(Minimum Fee uf$5p,00)
<br /> � �. `��
<br /> � x.oizs$
<br /> (,Conti3Ct priCa) (�aioimum 550.60)
<br /> 2, S'�'ATF SURCHARGE
<br /> x .d405 $
<br /> {cunir���icaj �
<br /> 3. POSTAGE&HANDLING(Only on Mail-Tn Applications) $ 2.00
<br /> 4. TOTA�.���z�rrr����Aaa�.�nzs �-3 Abovc) Ss_. .
<br /> ■ * CONTI2A,CT' PRTC'� c�r lfJB CC3ST mcans the actuai or estimated dollar amot�nt chaYged far the
<br /> pernvned wark inciuding mat�ri�ts,tabor,�rofi�and other 6�ced costs, it fs the anwunt ta bC charged
<br /> to the Gustomcr for the wor�done. Tf any ms�erisl, zc}uipr�,cnt,I�bvr ar ir�st�Itaiiorts are �emtished by
<br /> the owner,tenant or any other party,zn� reasuttable marker va�ue af such items mF:st be�dc3ed to ihe
<br /> c:snm$ted eost ar enna-act price for permit fee purposes. In the event d�at therz ��.s a dispute on ttte
<br /> �rnounr of rhe job cost,t1�c City may r�u�st the�ubmission of a signed copy of�he sctuai ccmtract.
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<br /> The undersigned hereby applies t�the City for issu�uice of a Mecha�tir�l Permii, agre�s to do a]I
<br /> work in strict accordance with flie orduiane� of the City and the reg�lstion-: of the State of
<br /> Minnesat�., �nd crrtities that aIl stateuients made on this a{�plication are complete, true and
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