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t ...__...._...�_ - <br /> �':�Rl�1�T�`l�E CALCI,JI,�TiQi�l(�) - <br /> __ ---------_�.�.W.. <br /> _BA5ED_�FF - 2002_�TATF? S�'ATUE '' <br /> ❑ Ye�,this section applies ��� � <br /> "i�lie t•epiacement of;t Residentiat fixture or_a��_iance that�neets�Il tlu�ee�f 1he follovv]��;re��uu•emettts: <br /> 1. f�oes not require modification to electricai or�as ser��ice. <br /> 2. 1-(as a total cost of$500.0f)or less;excludit�the ce�st <�f the fixture or appiiance: �nd <br /> 3. Is improve�i, i�istalletl o��rep(aced by the l�omeowner�r Iicensecl contractnr. <br /> Skip 3iext section, if this applies; C'ost of Yermit: <br /> �--- I 5.O0 <br /> State Surchars;e � 5� <br /> Mail-ln Fce(If'npj�lic�ble) � �.5� <br /> ��ot�) Permit Fcc � ` <br /> T __� <br /> __ _------pE�2'Mi"�_T���C�t��'u�,A'�TON��j .rC�B�UV�R�500�.00 � <br /> � _ ---------___.�-- -- -- -- _._�� <br /> 1 f�hnve does not apply; follo�v guidelines helow: <br /> 1. ('ONTRACT PRiC� ^ is 1.25"/�of contract.rn-ice with a(Nfinimnm Fee of$35.0p) <br /> ���" oU <br /> ''� x .f)!25 $ �� -� <br /> (crnitt;�ct��ricc) - --�—_--�--_�—__— <br /> fminimum�3�,(1��) <br /> 2. STATE SURCHARGr '"` ndd the State 131dg C'ocie 1)iv. Si�rchar�e(Minimum �ce�f$.5(�) <br /> � a, �� , �����5 � �,�° <br /> � � -� - __ _ ____ <br /> onfrac pncc� Iminimum.4� .Sl)) - — <br /> ;. POS't�AGE& 1-ti1NDI,W(i(Only�n Mail-In �pplir.ations) y,-- <br /> -- 1.50 <br /> ---------- <br /> 00 <br /> 4. 7'()�'i1i.,PF,RMtT �I;1?{nrld I.ines l-3 /1h�ve) g;� � �, —' <br /> " � ('C)NTR�C'i' PR1CT: or JOB C'OST t11P.8�1S tI1C 1CIllflI nr estimlted d�llar amoitnt chm��ed for the <br /> ��ermitted work including materiais, fabor, profit,and other tixed cc�sts. It is the amnunt to he ch�r�ed <br /> to the customer for tiie w�rk done, Tf�ny�naterial, ec�uipment, lahor or installations are fiirnished hy <br /> the nwner, tenant or any other }�Trty, the reasonable market v�itie of s�ich items nu�st be added to the <br /> eslimate�l cost or contract 4�rice ftir ��ermit fee purp�ses, ln the event th�t there is a clispute on ihe <br /> �tm�iu�t of�t:he job cost, the City m�y request the s�il�missi�ii c�f 1 si,gned copy of t1�e actual �ontract. <br /> ^ �`*'fhe S'f�TE SURCI-{�1RGE is .t)S)05 ofthe 13uilding Dep,u tment af(952)2q9-4(,pp f��•t:l�e price. <br /> — <br /> � --- ---------MEGHANI�:,4:L P�'RM�T A`f�I'I,I�C'A TlnN AGFtEEI�EiYI'T` ;'; . <br /> The �►nde�si�i�ed 11ei•eby :�Uplies t:o 11�e City for iss�.�ai�ce ��f a Mechanical Permit, agrees to do all <br /> �-vc�rl; ir� .�tricY accordance witii tiic ordinaucc;s of r.he ('ity ancl the regtrlations of tlle State �f <br /> Minnes�ta, and cei•tifies that all statements m�de c�n tlii.s a����licatic�n are complete, t�•ue and <br /> ccirreci. <br /> A��pliclnt's �i�niture: _�_.__ Date: d <br /> _ _ ��ae{�------ <br /> • Reset�orm <br /> , � <br />