Laserfiche WebLink
. . <br /> � � �- � ��;, �, r }��r ��.� <br /> �;"��, �' t t� �,�� � ��1�'�� x�Y� .',y,�. r� �,,t��n . �I��x��•-�'� *�k�v� e��'t��qd � S�� <br /> ��� �� v j,�*�: <xr��x�;w x, .�.kr"o�;�s��`".k.y`�,"�`����$i. ;"��;s.nti` <br /> ❑ Yes,�is section applies <br /> The replacement of a Residential Sxtut+e or appliance that meets all three of the following requirements: <br /> 1. Dces not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excl ' the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip ne�rt section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Totg1 Permit Fce $ <br /> ?�� y� }�f ���` <br /> ,fi� y�i Np J d��' �� .�:J r �Zb��k} 1;�?r�e l'r <br /> If above dces not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Miaimnm F�of 550.00) <br /> b���~� x.0125$ <br /> (contzact price) (mi0imem SSo.00) <br /> 2. STATE SURCHARGE <br /> x.0005 $ <br /> (conaact Price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amoant charged for the <br /> permitted work including 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,equipment, labor or ins�tallations 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 putposes. 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 /> Y <br /> 4��4�fPr p���.� a�'e�v''��� ���°i.'�... �`„�r�.ti �{;'s.'x� <br /> T'he undersigned hereby applies to the City for issuance of a Mechanical Permit,agrees to do a11 <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, �nd certifies that all statements made on tk�is application are complete, true and <br /> correct. <br /> Applicant's Signature: Date: ���2-O—�2 <br /> ���.�� , h �� :� � w�� ,�� <br /> � �{1 , <br /> xkV+ <br /> . . . ,. .„ � ��� �4,/`�d�".d,. <br /> 3 <br />