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. • <br /> � . <br /> ❑ Yes,this section applies <br /> The replacement of a.R�e j��ential fixb�re or�p 'An�that meets aif three of the fotlowing requirements: <br /> 1. Does not reqvire modification to electrical or gas service. <br /> 2. Has a 1 cost of$500.00 or less; cl i the cost of the fixture or apptiance:and <br /> 3. Ts improved,installed or replaced by the homeowner or iicensed contraetor. <br /> Skip next section,if this applies; Cost of Pernut $ 15.00 <br /> Stats Surchatge $ S,pp <br /> Ma.il-In Fea(If Applicabie) $ 2.00 <br /> TotaE Permit Fee $ <br /> If above does not apply;foilow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a{Minimum Fee of$5d.00) <br /> � <br /> l'��.a�•U�% x.or2s$ �� •1>> <br /> C���ce) (mmfmu�sso.00� <br /> 2. STATE Stn?�'HARC=F <br /> ��I`� ; •OC.`? x A005 $ �'��� <br /> (conaact prioe} <br /> 3. POSTAGE&HANDLING(Only on Mait-In Applications) $ ,-�00--" <br /> 4. TOTAL PERMT£F'EE(Add Lines 1-3 Above) $ ��;.5,�(�,_� <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor,profit,and oth�fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material,eyuipment, labor or installations are fumished by <br /> the owner, tenant or any other party, the reasonable market value of such items must be added to the <br /> estimated cost ar contract price for pemut fee purposes, In the event that there is a dispute on the <br /> amount of the job cost, the City may request the submission of a signed copy of the actual eontrac� <br /> The unc�eZsigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do alt <br /> work in strict accordance with the ordinances of the City and the reguIations of the State of <br /> Minnesota, and certif'�es that atl statements made on this application are complete, true and <br /> correct. <br /> ..�- � /_/._� <br /> Applicant's Signature: ��(�,�`�,��L y �,�,(,L��_►wc..L'L Date: �!`(�' ZO/�-'� -- <br /> D <br /> 3 <br />