Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
06-09—'15 16:15 FROM— T-890 P0006/OOQ7 F-079 <br /> $ <br /> ❑ Ycs,this section applies <br /> The replacement of a ResidenCial fxtura or appliancc that mects all three of the following requirements: <br /> 1. Docs not requ'rre modification to electrical or gas service. : <br /> 2. Has a tota s of�500,00 or less;excludin the cast o�the fixture or appliance:and <br /> 3. Ys improved,installcd or repfacCd by the homeowner or lieensed contractor. <br /> Skip next sectron,if this applies; Cost of Permit $ 1 S. <br /> Statt Surcharge $ 5.00 <br /> Mail-In Fea(rf Applicable) $ 2.00 <br /> Total permit�ee $ <br /> /� �. P� <br /> �'S. 1 Y � y .�5, ��kCi,� ..f;R�i?, r,��. <br /> Tf above does not apply;follow guidelin�s below: , <br /> ' <br /> 1, CONTRACT�'YtY�� *is 1.25%of contract price with a(1Vlinimum�ee of 550.00) <br /> $222020 t.'"��pl' " y";v��-:�:+�S,Q::{1.0'�>.;y��:,:,�;.;;;.:.�:,.� :, <br /> �:: :2��� ;�., . <br /> �(�v'. ��'i�Cn'' (m nirti.,�:��� � <br /> t <br /> , <br /> 2. STAT�SUR(`.�TARG� ' <br /> $z,220.20 x�4:��°n':�� 1.11 t <br /> .y.. �. <br /> ���1 ..!a.i )t � <br /> 3. I�OS'1'ACr�t��]ANDLING Onl on Mail-In A lications f�w0(l,';`r.���^ �'°� <br /> ( Y pP ) �'�3., . , .. ... _ �„���F;�.,: <br /> 4. TOTA�.�'��tMYT�'�E(Add Lines 1-3 Above) �wP+.�'i:':��5•�('s.`��<'�`'�.�.p��":��?���?-£ti�' <br /> ■ * CONTRACT PRICE or JO$ COST means the actusl or estimatod dollar amount chxrgtd for the <br /> permittcd work including materials,labor,prof,t,and other fixod costs. It is thc amount 10 bc charged ; <br /> to the custorner for the work done. If any maCtrial,equipment,labow or installations are furnished by <br /> the owner,tenant or any other party,the reasonabte market value of such items must be added to the ; <br /> estimated cost or contraeC priee for permit fee purposes. rn the event that thoro is a dispute on the <br /> amount of the job cost,the City may request the submission of a signed copy of the actual contraet. ! <br /> � <br /> I <br /> � <br /> � i <br /> ,t7.. �'.i_ �. .V". !f. s..S1=Fi(..�e,!'�;';i;�}��13,+;:i •.y�����e3��:r�'�! � <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all � <br /> r,vork in strict accordance with the ordinanees of the City and the regulations of the Stat� of � <br /> Minnesota, and ce�tifies that all statements madc on this application are complete, true and � <br /> correct. � <br /> f _-� . E <br /> Applicant's Signature: C� C�!/�/�'f^����"N '�.'�,.�a'� 6/9/15 { <br /> � <br /> t <br /> � <br /> � <br /> 3 � <br /> � <br /> I <br /> 1 <br /> � <br /> i <br />