2006-P10253 - mechanical - Laserfiche WebLink

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• �',2 iA& rt.=t� 4.��...�pay�t7't +•__' v a6 t.s, «•i �T' .-.. f Yes,this sectio n applies ;.A The replacementof a R sidential fixture or appliance that meets all three of the following requirements ' ' F � • 1 Does not quire modification to electrical or gas service. to k i • 5 � Y Has a tota'cost of$500.00 or less;excluding the cost of the fixture or appliance ands r , 3 Is improv•d,installed or replaced by the homeowner or licensed contractor ' • Skip next ection,if this applies, " Cost of Permit $ 150 $ , State Surcharge • • Mail-In Fee,(If Applicable) • r ,5 # 5r4 Total Permit Fee $ i it wbah 7i . � 'y} L' • r n If above does not apply; ollow guidelines below • " 1. . CONTRA I T PRICE *is 1.25%of contract price with a(Minimum Fee of$35 00) 10 .0 00 x.0125$ `) -I (contract price) (minimum$35.00) 2. STATE S CHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of S.50) x.0005 $ )(contract price) (minimum$ .50), 3. POSTAGE HANDLING(Only on Mail-In Applications) $ • 4. TOTAL PE'• T FEE(Add Lines 1-3 Above) $ 1 3 0,- ▪ * CONTRACT PRISE or JOB COST means the actual or estimated dollar amount charged for the permitted work inclu.ing materials,labor,profit, and other fixed costs. It is the amount to be charged to the customer for I- work done. If any material, equipment,labor or installations are furnished by the owner,tenant or .•y other party, the reasonable market value of such items must be added to the estimated cost or cos.act price for permit fee purposes. In the event that there is a dispute on the ... amount of the job co•t, the City may request the submission of a signed copy of the actual contract. • **The STATE SURS' • 'GE is.0005 of the Building Department at(952)249-4600 for the price. 911 o 631 , P; tL r`? , `6R 4m, The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all work in strict accordan e with the ordinances of the City and the regulations of the State of Minnesota, and certifie that all statements made on this application are complete, true and correct. Applicant's Signature: w+ Date: 6/Z VOG;, • 3