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<br /> Oct-20-2008 04:21pm From-CITY OF ORONO +9522494616 T-862 P.003/003 F-144
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<br /> (� Yes,this section applics
<br /> �'he rcYplacemenc of a ReSide t2n 'al fixnuc or appliance that meets all tl�ree of the foliowin�requirements�
<br /> 1. Docs not requite modification to elec�ical or gas service.
<br /> 2, Has a tncal cost of$500.00 or less;excl 'n tl�e cost of the fixt�uc or appliancc: and
<br /> 3. Is improved,insralled or rE�placcd by the homeovvner or licensed contractnr.
<br /> Skip next section,if this applics; Cost of permit $ 1�.00
<br /> State Surcharge $ .50
<br /> Mail-In Fee(If AppliCable) $ 2.00
<br /> Total permit�ee $
<br /> �R (I 1(
<br /> 1�I �)� k j �� �� � �� 1 Nif'I��I I ' 1 I��
<br /> L IfJli� l ��I���� ���• �1 MIAf1I 1.��' .I..� u'.i .�u . i'��•��. I�'�i�4��7�I�Ij4��c'��l�i�'�1�/���II�h
<br /> If above does not apply;follow g��idelines below:
<br /> 1. CONTRaCT PRICE * is 1.25%of con�ract price with a(Minimum�'cc of$50.00)
<br /> ����) X_o�zs$_._� ��a-�
<br /> (con�racL pricc) (i�iinimum�SU.UO)
<br /> 2. STAT�STTR(:HARGE ""'Add the S[acz Bldg Code Div. Surchurge(Minimum�'ee of 5.50)
<br /> x.0005 $ � •��
<br /> (Contrnc�prica) 1 ininimum$ .SO)
<br /> 3, pOSTACrL c�T�A,NFaI�P.VG(Only on Mail-In Applications) $_. 2.00
<br /> 4. TOTAL P�RMIT FE�:(Add Lines 1-3 Above} $,�_l ` 1 vv
<br /> ■ * CONTRACT PRICE or JOB COST means the �ctual ar esrimated dollar am��unt cl�a�•ged foi• the
<br /> permztted work including macerials, lflbor,profit, and othzr fixed eos[s. T[is che xnwunt to be eliarged
<br /> to the customer for rhe work done. If any material, equipment, labor or insiallations are furnished by
<br /> zhe owner, tenant or any otlirr parly, the reasonablz mnrket value of such items rnust be added to the
<br /> estimatcd cost or coniract price for permit fee purposes. In the event that cher� is a dispure on rhe
<br /> amoun; o:the job cost, thP Ciry nzay raqucst the submission of a signed eopy ot�thc actual canµact,
<br /> ■ **The STATE SURC�iARGE is.00OS of the Building Departmznt at(952)249-46Q0 for tlic price.
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<br /> ��15(�.'�.{I��;��,fl�iR��il,) ,.N 1��!I� �Wl� � i� �� r��fi.l:��,i��f�f6,�����JItI�,�n Y�.l��l���j�f(�i
<br /> The undersigned hereby applies to the City for issuance of a Mechanieal Pen�lit, a�rees to do a11
<br /> work in strict accordance with the ordinanc�s of the Ciry and Th� r�gulatiuns of the State of
<br /> IV�innesota, and certifies thnt all statements made on this application are �;omplete, true and
<br /> correct.
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<br /> Applicant'>Signature: �'��"�` ' �/��' Date:�_�.�
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