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10{2�i2F�i1 15:30 DITTER INC � 9522494616 N0.719 D01 <br /> . ���✓' i��,,<'�w l�gSz-� �g --�' �'� <br /> , �� DS �%�iw a .�, <br /> . <br /> � <br /> ❑ Yes,tl�is section applics <br /> 'Che replacement of a R id.an ial fixcure or�► lia ce that meets all three of the follow;ng raquiremeou: <br /> 1, �oes not.require mocli�cation to electrical or gRs service. <br /> 2. 1-�as a rotal cost of$500.00 or Ices;exc�u ' tha cost of tl�e fiixtu�e or appliance: �nd <br /> 3, ls improved,installed o�repl�ced b�the homeowner or licensed eontractor. <br /> Skip next secCion,iTthis flpplies; Cost of Permic � 15.40 <br /> State Surchargc $ .50 <br /> M:►il-In Fae(Yf Applicable) $ 1.50 <br /> Totnl Permit Fce $ <br /> � n � �!' �„ . .. <br /> lf above does not ap��ly; follow guidelines below: <br /> 1. CONTRACT p�t�CT� • is 1,25%af conuact price with a(Minimum �'ee of$35.04) <br /> �'Lsm°•d� x.o�2ss ��8. 7 <br /> (aontraot price) (minimum S35 00� <br /> 2. STAT�SURCHARG� '�'"Ad.d the State Bldg Code Div.Su�charge(Minimum Fee ofS.50) <br /> ✓ 5 �� x.U005 $ 7 <br /> (aonUect price) (minimum .50) <br /> 3. POSTAa�6c 1lANb�,ING(aoly on Mail-Cn Applications) � 1.50 � <br /> �. TOTA�p�RMiT FE�{Add Lines 1-3 Above) S �2�'� <br /> ■ ' CONTRE4CT AR10E or 1Qb COST means the actual or estimated dollar �rnount charged for the <br /> permiCted work includiog mo�erials, labor, profi, ��d other$xed cosTs. .Ct is the amount to be cl�arged <br /> to the customar for tl�e work do��e. If any material, e9uipment, lab�or o.r installations a�•e furnished by <br /> the owner�tensnt or any other parry, the reasonablo mftrket value of suclt iterns must be adtled eo tl�e <br /> estiroaTed cost or eontraet �rice 1'or permit fee pur�oses. in tha event that there is a dispute on tlu <br /> amount of the job cas�,rJ�e City may request the su.bmission of a signad copy of the accual contract. <br /> • '�°' The STATE SU.RCCTAR��is .0005 of tlte 6uilding�epartntent at(952)2h9-4600 for the price. <br /> The u.ndusigned hereby appl.ies ta tl�e City �'or issuance o�a Mechanical Permit, agrees to do all <br /> wvork in strict accordance with th.e ardinances of tlie Ciry an.d the regulations nf the State of <br /> Minnesota, and cer�ifies that all statements .made on t11is applicatian a�e coinplete, true and <br /> correc�, <br /> ,, �� "" �� /o t,o /� <br /> Applicam s Si�nature: Datie: � � <br /> � , ,t,,i i i i <br /> ,� <br /> 3 <br />