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01-11-'17 12:31 FROM- T-681 P0003/0004 F-829
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<br /> ❑ Yes,this section Rpplies
<br /> The replaccmcnt of a Rcsidendal fixture or a iancz that meets all thrtt of the following requirements:
<br /> 1. Does noi requira modification to electrical or gas serviee.
<br /> Z. T�as a total eost of$500.00 or less;excludin�the cost of the fixture or applianee:and
<br /> 3. Is improved,installed or replaeed by thc homeowner or licensed contraetor.
<br /> Skip next section,if ihis applies; Cost of Permit $ 15.00
<br /> State Surchargt $ 5_00
<br /> lv�ail-In�e�(Tf Applicable) $ 2_00
<br /> Totalpermft Fee $
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<br /> Ifabove does not apply;follow guidelines below:
<br /> 1. CO1V'Y'�tA,C`x'PTiYC� '"is 1.25%of contract price with a(Minimum 1Fee o�'$50
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<br /> convacc price) (n�foimum 550.00)
<br /> 2. STATE SURCHARG� � ��r" ! "y
<br /> -� x.0005 $ �lL�I
<br /> camrnct price)
<br /> 3. POSTAG�&HAN7�LTNQ(OnIy on Mail-In Applicatipns) $ �,�
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<br /> 4. TOTAL PE1tMIT Y�E�(Add Lines 1-3 Above) $ .
<br /> ■ # CONTRACT pRTCE or JOB COST means the actual or estimated dollar amount charged for thc
<br /> permitted work including mt�ttrials,labor,prpfit,and other fix�d costs. Tt is the amount to be charged
<br /> to the customer for the work done. If any material,equipment, labor or 3nstallations are furnished by
<br /> the owner,tenant or any other parCy,the reasonable markct value of such items must be added to the
<br /> estimated cost or contr�et priee for permit fee purposes. In the event that thera is a dispuie on tlie
<br /> amount of the job cost, the City may request the submission of a signed copy of the actuai contracE.
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<br /> The undcrsig�ed hcrcb�applies to the City for issuance of a Mechanical �ernnit,agrees to do all
<br /> �vork in strict aecordance with the ordinanees of the City and ttie regvlations of the State of
<br /> Minnesota, and certifies that all statements made ihis application are complete, trne and
<br /> correct_
<br /> Applicant's Signature. Date: � ` �r� �
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