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F-;om:B&D PLUMBING 7634974263 10/09/2013 14:43 #026 P.007/007 i <br /> I <br /> r <br /> 1 <br /> XYes,this section applies <br /> The replacement of a Residential fixhae or alrpliance that meets all time of the following requirements: <br /> 1. Does not require modification to electrical or gas service. s <br /> 2. Has a total cost of$500.00 or less;eexcludinn 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-ba Fee:(If Applicable) $ <br /> Total Permit Fee $ <br /> r <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(b1iniiaam Fee of$50,00) # <br /> x.0125$ <br /> (Coafta price) (mintmuum"0." <br /> 2. STATE SURCHARGE � <br /> X.0005 $ <br /> (Conrad Pm-) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> i <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> ■ • CONTRACT PRICE or JOB COST means 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 j <br /> estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the 1( <br /> amount of the job cost,the City may request the submission of a signed copy of the actual contract. <br /> I <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 Si ure: `1./e`d. Date: <br /> PP � ._, i <br /> 1 <br /> 3 <br /> s <br /> 1' <br /> r <br /> i <br />