Laserfiche WebLink
. <br /> �A / � �: A ��", � ,� �������� .' � : <br /> ri+ y�; <br /> v�� � j,[� � <br /> �� � . �� t�� ��� 4�✓s 6 ����t.l�`�,. ��s���' . ,���� r 4Q d��Fyj G '•n t�-a. .i.:. <br /> ❑ Yes,this section applies <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 senrice. <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 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 S <br /> Y � x ; P�tl�/�`P3 ��"�'�� Y � _�4�������.�t� - <br /> If above does not agply;follow guidelines below: "- <br /> 1. CONT'RACT PI�ICE *is 1.25%of contract price with a(M�nimam Fee of$50.00) <br /> ����t 0� x.0125$ �.+�b' <br /> (contract price) (minimum$SO.OQ) <br /> 2. STATE SURCHARGE 2 �1 !, �D <br /> ') '7��_ OV x.0005 $ `.,�� <br /> (contract Price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERNIIT FEE(Add Lines 1-3 Above) $ �7V <br /> ■ ' CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> pemutted 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 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 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 /> ";�,;, ; . -; :�EGk��I�TI��.,=PEI�'�`�"��-�'�1��'���'� �%��T ,: < . <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 made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: ��`�� ��� Date: y��,Z�Jd� ����G�O <br /> �� . � <br /> �,:= ��5���C�l'� .,:.� <br /> Ya _ <br />� 3 <br />