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• Oct-20-2009 04:21pm From-CITY OF ORONO +g522494616 T-862 P.003/�03 F-144 <br /> . <br /> 1'Hh"�r4 � i , �I �I ill�'ll 1 i �,I U�� . t' � j�'.I' � E r: � �1� <br /> rh�l i �� ��. ' ��r ' � i l {^� � � � � i� �i�E l� t � I11 �� ��y i �i � � �� <br /> I 1 fi � i� , � I � fi. <br /> ��� �i N� li���i �� I'����I�,f�� �� ��� �II i � ,f t, .� l ��I h,.�.,)�.,� q� �I� '��. � i�N�d ��V{ � �(� Il!' 1y I !�' � � ���i <br /> i i"�{ 1) ti r��.� 1 �� I�r�i��il I��i�l�lfi � MI �� �S�`����' i �r I ���i��(�I� f �'�fi I �j ��1�I�1������t�� II l�I�i <br /> Fr�1�� h�.�f�.�.r j ia��II{ � ��I,I �I.�;.�I,�I I�!`�I.i. .�f{I!,���iTtl � ��,NINA��1��IH:I��� �I.��I�i�i(V�. I�If.{r�ll���i�l.I.���({��•��l�.l�t��.�.i.11l'l <br /> (] Yes,this section applics <br /> The rc-placement of a Resident�al fixnuc or apptiance that meets all tt�ree of the followin�requirements� <br /> i. Docs nor requu•e modificatian t4 elec�ieal or gas serviee. <br /> 2, Has a tntal cost of$500,00 or less;excl 'n the cost of the fixturo or ap}�liancc:and <br /> 3. Is improved,insFalIed or rEYplaccd by rhe homeowner or licensed contracrc��•. <br /> Skip next section,if this applics; Cost of 1'ermit $ 15.00 <br /> State Surchax�;e $ .SQ <br /> Mail-In Fee(If Applicable) $ 2.40 <br /> Total permit�ee $ <br /> v�,������ E� �(r�{� <br /> �.� � I ��. .'i �MI�Rli .�li�i���t�� .��� i �i!.i .w ��'`71M N,I€���I;�l�6�����5���`��1i1�'���{0��I I <br /> , � � i , .. � . ' . <br /> If above does not apply; follow guidelines below: <br /> I, CQNTRACT_PRICE *is 1.25%of con�ract price with a(Minimum�'cc of$50.00) <br /> �od� X_o�zs$ .� <br /> (roncraci price) (�ninimum$SU.UO) <br /> 2. STATF SiTRC:H.��RGE ""'Add the Scatz 131dg Code Div. Surchf►rge(M inimum lEee of s.s0� <br /> x.0005 $ �•�� <br /> (ContrAc[priCd) {ininimum$ .SQ) <br /> 3. pOSTAGE&HANDLING(Only pn Mail-In Applications} $__ 2_00 <br /> 4. TQTAi.PER'VIIT FE�:(Add Lines 1-3 Above} $,____ _�•o" <br /> ■ w CONTRACT PRICE or JOB COST means thc actual or esrimated dollar am<�unt charged for the <br /> permitted work including macerials, labor,profit, and othzr fixed costs, It is ehe anwunt to be cl�arged <br /> to the customer for the work done. If any maierial, equipment, labor or installat�ons are furnished by <br /> rhe owner, tenant or any otl�rr paziy, the reasonablz markec value of such items rn�sst be added to th� <br /> estimatcd cosc or conrract price for permii fee purposes. in the event that ther: is a dispute on ihe <br /> amount of the job cost, the City n�ay rcquest the submission of a signed eopy ol'the actual contract. <br /> ■ **The STATE SURGHARG�is .0005 of che Building Departmznt at(952)249-a600 for tlic price. <br /> � J ,. I �"� '' ,i{ y�ry �'� 'FI f��: i� '';i �� i� i i � !, `� ' It t ' l., h' '' `,' <br /> ���: !i 11 1 l�li I� iti� � �i �ta:e��,. i��:iiU(�h,�,i�11�Jd�11r���I;;I�I l��;i <br /> The �u�dersigned hereby applies to the Ciry for issuance of a Mechanieal Pernzit, asrees to do a11 <br /> work in strict accordance with the ardinancas of the Ciry and �he regulatiui�s of the State of <br /> Minnesota, and certifies that all statements made on this application are t;omplete, true and <br /> correct. <br /> Applicant'> Signature: Date: ��V�V �� <br /> 3 <br />