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12-28-'17 12:45 FROM- T-348 P0003/0007 F-759 <br /> , <br /> lam. 5 �� `,`» i t .e]rii, his igoilr i1et Fiffi1.ai ,✓�lki-told '�I :! -Tr t <br /> Ili Yes,this section applies <br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> I. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excluding 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 /> . •...._ <br /> W..0 �i II!�'o$lA401,f,�ft�4:0 .0 -��t-'----:4'1:(14,'S"'iftD B`$ �Vl 'tt j 9 t rOJ'. T,`"';;'A'';.%! <br /> If above does not apply;follow guidelines below: <br /> I. CONTRACT PRICE ' is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> 1-15106.-- x.0125$ 57 <br /> (Contract price) (minimum S50.00) <br /> 2. STATE SURCHARGE <br /> 1-5-6,0� <br /> x.0005 $ <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ CA I <br /> ■ * CONTRACT PRICE or 70)3 COST moans the actual or estimated dollar amount 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 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 /> k ,:.,.r .i ."'' 4.f._ C i 5..rV.A01041TrAl_A`R:40;v/11l,i'�'1R0 S�1.1'I.�NI C.�i`1n7y :77 t:It .;. <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 Signatur, _ Date: ) 7-/Z47' 7 <br /> 3 <br />