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SEP-24-2002 TUE 01 ;54 PM MinnDak Mech Inc/Norse FAX N0, 763 441 9040 P, 04 <br /> Sea-18-x0oT 01:17pm From-CITY OF ORONO +9522494616 Y•016 P.006/0�6 F-136 <br /> ��t��T��cA�ctn�,ax�coN�s� <br /> � �tato te []Yes'�his Sactim Applies <br /> The replacem�nt of a si_dcntial fixtwe or�p,pl9anee that mcets all chree of�he following rcquirements: <br /> 1) �es not rcquire modification to electrical or g,as service. <br /> 2) Has a total cosc of$500.00 or les�;�xcludine th�cost of the fixturo or appliance; <br /> gncl <br /> 3) Ts irnproved,ins�alled or replaeed b�rhe homeo�ynec or lieensed cee�tractar, <br /> Skip ncxt s�ction; Cost of Permit $ 15.00 <br /> State S►trcharge$ ,SO �� <br /> Mail Yn Fae $ ,,, ].5(I <br /> � <br /> If abovc does not apply,follow guidelinrs below: � <br /> 1, Con�rR�t Price�is,U125°10 of job wit}►a�,V�,imum Fee of f�3S.00) � <br /> � �u, /�O x.0125 $ �'/�.� $ <br /> (conrrncrpriec) (ttlin(mufi�5.00) <br /> 2.State Sarchar�e.�''�Add the Sta���uilding Code Divislpn a�1'inimum F�e of,�(S S0� <br /> ��,�r� x.000s $ �a,� 6 <br /> (conrrace price) (minimum S�50) <br /> 3. P �t��e and S3ndlin�(Only mail-�'�1 rtpplrcotions) $ _ 1.SQ <br /> 4.TOTAL pE�tM.Y'�FEE(Add lines 1-3 a6vve) $ ��0.��� <br /> +GONTRAC!'rRYCC or d013 COST meaqs[hc acntal or cadmatcd dollar amount chor��d for thc petmitted work In�ludin�• <br /> maieriul�,lubor,proGt,aad nrher 8x�d cosss.Ic Is�he amount to b��har��ed to rhe custcmer�(br[ha work dont.If any m�aulnl, <br /> equlpmcnt,labor,or tr�srallaiion is f�mish�.d by�he owner,ttnant or any other pa�y�e re�onable market value of svch item9 <br /> mu3�ba addest to t�o e3cimated co�t ar eontract pr#ec for ptnnit fee purpoees.In the aveqt ehaz therc 1s z dispu�u on the nenount of <br /> tiha Job eos[�the Ciry muy rcquesc Yht submission of a signed copy Of the ac�u�1 eon�rac�. <br /> "'"Thc STATE 5'CIP.CHARGE is�0005 of tE�a cantrncc price under S 1,4aD,000 or�.SO-whichcver�s grcarer,For valutitions ovor <br /> $1,Q00,000 eall the l7cpattmcnt of Inspeetional S�rviees for ehc price. <br /> Thd updersigned hacby applies to tnc Cily for Jssu�ncc of a Mcchan icul Pcrml�,o�sas co 9p n)l work in suict acco�dMCQ wl[h <br /> Che qrditlenets of ihe Ciey and the re�4lntians of thc Minnzsou�Stald Buildlt'ig Code,and ccrtifies ehat aIl swrements mnde on shis <br /> uppllca�ion ere compltte,true and toncc� <br /> A��alic3nt's Si�rtaturc: ;�---•� Date: �'� �07— <br /> Approved Iiy: Dato: <br /> 3 <br />