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<br /> ❑ Yc.w,this seaion a�plies
<br /> 'Ihe repla�xment of a$�y�e�tia�fizture or�pJ j�g thet moets all throe af the follm�ving roquirCmr.mis:
<br /> 1. �t+equire mudifieetion to electrical or ges service_
<br /> 2. !les a�tal cost oI SS00.00 or less;�ccludine the aut of the tixtune�applisnce:and
<br /> 3. ls improveci,in�lled or roplaced hy tha hoine�mcr or li�a.�d oonuscxor.
<br /> Sk�p next section,if this applies; Cost c�f Pe�mit � IS"00
<br /> state Surchargc S .50
<br /> Mail-In Fee(�f Appiicable) S 1..59
<br /> Toai Penmlt Fee S
<br /> ��l.�;.:;,e:li��, f •�rtif �^ � "I�<�'1'�'�. : 1'. .•7
<br /> If abave does not apply;fiollow guidelines below:
<br /> 1. CONTRACT PRtC� *is 1.25°X.of oonhacti price with a(Miaio��a F�ee o�535.00)
<br /> 11,180.00 � 139.50
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<br /> (�pioe) (udNmum 535.00)
<br /> 2. 3TA'IT SUB fARGE s•Add the State 131dg Code Div.Swcharge(Mleisn�Fee otS.SO)
<br /> 11�160.00 . x.UWS S 5.58
<br /> (oom.xprme� (minin.�m: .soj�
<br /> 3. POSTAGE&EIANDLiN(3(Only on Mail-In Appliceticros) S LSQ
<br /> 4. TOTAL P�RMIT FEE(Add Lines 1-3 Abave) S ��'�-
<br /> • ' CON'1'R.ACT PRICE or JOB COST mosns the actual or eatimated clollar amount chsrgod for the
<br /> permitted w�ork including meterials,labor,proftt,attd othec fixod cosb. it is thc smount�o be eherged
<br /> w the a�stomcr Cor the work done. LL"any material,equipment,laborr or inslalletions are ti�miahed by
<br /> ihe owner,tenant or eay other par�y,th�reasonable market value of such i�ems musc be add�ed to the
<br /> estimated oosc or oontrect p�loC fo�permit fee purposes. In tho event that thare is a dispub��m du
<br /> amount of�he job oos�the Gity may request the sub�is.�ion of e signod oopy of the aca,al oonuact.
<br /> ■ '�"The$TATE SURCNAR(3S is.0005 of the Building De�ent at(952)245�-460Q for the price.
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<br /> Th�undeasigned hereby applies to the City for issuaace of a Mechanlcal Permit,sgrees to do all
<br /> work in striet accordeace with the otdieances of the City and the regulations of the Stete of
<br /> Mianesota, and ce�ti$es tt�at ail made on thia application are complete, true and
<br /> con�+ect.
<br /> �
<br /> ` 10/06/08
<br /> Applicant's Signatuto: Date•
<br /> ,,��.���'!!��:.;.,..;�:,�' � 3
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<br /> �3Jtid 8SbSZ9S8Zzti S1�13dX �IOIa31X 8S�80 800Z-ZZ-OZ
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