Laserfiche WebLink
Mar. 24 2014 1 : 58PM HP LRSERJET FRX page 4 <br /> ❑ Yes,tfus section appl9ea <br /> The repleceme�rt of a Rasidetttial_f��Le or auplia�ce thet rnaets a1I three of the following requirements: <br /> 1. j2�s nQ�requine modSfication to electrical or gas service. <br /> 2. Has a total cost of$5�0,00 or less;gg�]��the cost af the fixtw�e or appliance:and <br /> 3. Is improved,instal[ed:or replaced by the homeowner or lioensod centractor. <br /> Sldp ncxt section,if this applies; Cost of Permit ��� <br /> State Surcharge $ 5.00 <br /> �Iail-In Ree(If Applicable) $ Z.00 <br /> Total Permit Fee � <br /> If abova does aot apply;follow gui�elines below: <br /> 1. CONTRACT PRICL +is (,259�0 of contract price with a(Minimum F�of SS0.00) <br /> �.�511��. X.oi2s$ �3.?,S <br /> c�P��) cai■+mnn sso.00� <br /> 2. �TATE SURCHAR� <br /> x.0005 $ Z. �� <br /> <oamact priCe) <br /> 3. POSTACIIE&HANDL�NQ(pn]y on Mail-In Applications) $ 2A0 <br /> 4. TOTAI.PERMIT 1�'EE(Add Lines I-3 Above) $ (p���� <br /> ■ * CONTRACT PRICE or JO� COST meana the actual or estimated dollar amount charged for the <br /> pecmitted work ineluding mateqials,labor,profit,and other fixed costs. It is the amount to be charged <br /> to We cusWmer for tho work d�ne. If any material,equipment, labor or installations are furnished by <br /> the owner, tenant ar eny oth��,the reasonable market value of s�ch items must be sdded W the <br /> estimated cost or oontract pri for permit fee purposes. In the event ihat t�ere is a dispute on the <br /> amouat of the job cost, the Cidy may requ�t the submission of a signed copy of the actual condract. <br /> The undersigned hergby applies �o the City for issuance of a Mechanical Perrait,agrces to do all <br /> work in strict accordance with �he 'ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all st�atements rnade an this application are complete, true and <br /> coaect. <br /> APPlicanY s Signature: , Date� �Z'�F-��4 <br /> 3 <br /> I . <br />