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08-14-'16 13:21 FROM- F I RES I DE T-415 P0003/0004 F-961 <br /> �, �a; �-� _ k�" t' �uk�„ <br /> u � �� � <br /> r � �`��" <br /> ,'�� p � �'iu..,,�,.kr... ��t:�..,. `�7i.�iL:!�.i <br /> � Yes,this section applies <br /> The CeplaCement of a_R_esidential fixture or appliance thaf ineets all thrcc of Ihe follo�ing requrCements: <br /> 1. D�es not require modification to electrical or gas strvict. <br /> 2_ Has a total cost of$500.00 or less;excludin the cost of the fixture or appliance�and ' <br /> 3_ Is fmproved,insCalled or replaced by the homeownar or licensed cantractor. <br /> Skip next seetion,if this applies; CosC of perrnit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-Tn Fee(lf Applicable) $ 2.00 ; <br /> Total Perm�t�ee $ <br /> � <br /> ; <br /> � <br /> Yf above does not apply;follow guidelincs b�low: f <br /> 1. CONTRACT PRIC� *is 1.Z5%of contract price with a(Minimum Fee of$50.00) i <br /> �' �p i <br /> �°I�� x.oi2s$ ��O , <br /> contract pricc) (mioimum$50.00) <br /> 2. STAT�S�11l2('HARGE �� r-. �� <br /> a� x.0005 � �- 4 <br /> (contract priCe) <br /> 3. POSTAGE&HANbLrNG(Only on Maii-In Applications) $ <br /> n q� � <br /> a. TqTAL PERMIT FEE(Add�,ittes 1-3 Above) $ �" ' -/ <br /> ■ � CONTRACT PRICE or JOB COST means the actaal or estimated dollar amount charged for the <br /> permitted work including materials,labor,profit,and other fixed costs. It is the amount to be charged � <br /> to the customer for the�aork done. Tf any material,equip�nent, labor or installations are furnished by <br /> the owner,tenant or any other party,the reasonable market vafue of such items must bo added to the <br /> estimafed cast or conhaet pciee for permit fee purposes. In the event that there is a dispute on thc <br /> amount of the job cost,thc City may request the submission of a signed capy of the actual contract_ <br /> i <br /> � <br /> 1 <br /> A' ' .y �,S �. .,R�i i <br /> � � � <br /> i <br /> The undersigned hereby applies to the City for issuance of a Mechanical Fe,mit,agrees to do a!1 <br /> work in strict accordance with the ordinances of the City and the regulat'rons of the State of � <br /> M'rnnesota, and certifies that all statements made on this application are complete, true and E <br /> correct. � <br /> , ,� / ; <br /> Applicant's Signature: . ✓,�`� ��"✓'J Date: � �U—1 � <br /> f <br /> � <br /> 3 <br />