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�� v�ulllh�lil���lll Ir�� �.�I� r�hXl�il�j)� 7'�+' /^+� _ T � � ��� pI� �III�IH�,^���i��liN �.'� �il", <br /> r I�ill��II� I�II ii i s�y�uo��.:° I�9h� �jL l��L����4�� l� � ��+�i 'I �yf I IV 14 d � Iili I , 4 <br /> � iI��II�iIIIIIIIIj�IIIIIYIIII�llllhl� i �; ��(�!�� � �� � � �� � p�I YI�I��Illl�i�ii ��h M�s �;,"�r����: <br /> �., , i Vlil I��a�� — ����������Y����� ..�� � ��� 4P'.�i�P�".,��.� ��III'��u�kll�llv�r�lJ1.r . .��II��II�'.t�� ��� <br /> � Yes this section a lies <br /> ❑ , PP <br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> i. �i i w n i �T � �i �y v�ry Ilutll ufl1. �i �! iN iii <br /> i�u� +i��1.��i�������+����ly � -���� v �� ' 1� 11� _,�,�s.V'i tllip�ul�i'��i�. <br /> If above I r '.: <br /> does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract rice with a(Minimum Fee of$50.00 <br /> - 8,100.C�0 101 .28 <br /> X.oi2s$ <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE 8�'� o o.o 0 4.0 5 <br /> x.0005 $ <br /> (contrac[price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � �7.33 <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work includin�materials,labor,profit,and other 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 furnished by <br /> the owner, tenant or any other party,the reasonable market value of such items must be added to the ' <br /> estimated cost or contract price for permit 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 contract. <br /> �',:.�r.��S.'��I�r'-'",'.,i}�.�W.`F`�.e�4'.+*+1��� =����". �4 � �-_�_'-_��.��� ,.,ar, <br /> ,. <br /> �,, I .� .��, <br /> �,.� I .. . _; <br /> ` <br /> The undersigned hereby applies'to the City for issuance of a Mechanical Permit, agrees to do all <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statements ma e on this application are complete, true and <br /> correct. <br /> ApplicanYs Signature: Date: � �� O��I <br /> � ���f�es�X ��arm ' � ` 3 <br />