01-22-'16 13:04 FROM- T-594 P0003/0004 F-970
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<br /> � Yes,this section applies
<br /> The replacement of a Residential fixture or appliance that meets afl three ofthe following requiremcnCs:
<br /> 1, D,�g���ot require modification to eleotrical or gas service.
<br /> 2. �Cas a toral of�500.00 or less;excludin�the cost of the fixture or appliance�and
<br /> 3. fs improved,instAlled or repl�eed by thc homeowner or licenscd contrACtor.
<br /> Skip next section,if this applies; Cost of Permit � 15.00
<br /> State Surcharge $ 5.00
<br /> M�il-In Fee(ifApplicable) $ 2,00 c
<br /> Total Permit Fee �
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<br /> If above does not apply; follow guidelines below: �
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<br /> 1. CONTRACT��tYC� * is L25%of contract price with a(Minimum Fee of$50.00) p
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<br /> 1 � x.O 1'25$_��
<br /> (contracc price) (minimvm 530.00)
<br /> 2. STATE SURCHARGE � ���
<br /> x.0005 �: ��
<br /> �( ontractprice) i�y, ,
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<br /> 3. POSTAGE&HANDLING(Only on Mai1-In Applications) $ � i
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<br /> 4. TOTAL PERMIT FEE(Add�,ines 1-3 Above) $�� i
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<br /> • * CONTTtACT P�tCGE or �OB COST means the actual or estimAted dollar a►nount charged for the �
<br /> permitted work including materisls,labor,profit,and other fixed costs. rt is the amount ta be charged ;
<br /> to thc custorner for the work done. [f any material,equipment, labor or installations are fiurnished by �
<br /> the owner, tenani or an�other party>the reasonable market value of such iYems must be added to the �
<br /> estimated cost or contract price for permit fce purposes. In the event that there is a dispute on the :
<br /> amaunt of the job cost, thc City may requcst the submissipn of a signed copy of the actual contcact. !
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<br /> The undersigned hcreb� applies to the City for issuance of a Mechanical Fermit, ag►�ecs to do a(1 i
<br /> work in stric# accordancc with the ordinances of the City and the regulations of the SCaCc of ,
<br /> Minnesota, and certifies that all statements made on this application are complete, true and
<br /> co�rect.
<br /> Applicant's Signature: �"'��!��U��� Date: ! ��_��
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