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10-28—'14 14:49 FR4M— T-108 P0046/0007 F-220
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<br /> ❑ Yes,this section applies �
<br /> The replaeement of a Residential fixture or appliance that metts ail thrce of the following requirements:
<br /> 1. Does not require modification to electrical or gas service. �
<br /> 2. Has a total cosk of$500.00 or less;excludinc tha eost of the fixture or applianea:and ;
<br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. �
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<br /> Skip next seation,if this applies: Cost of Permit $ 15.00 �
<br /> Sfate Su►+charge $ 5.00
<br /> Mail-In Fee(Tf Applicable) S 2.00
<br /> Total�ermit�'ee $
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<br /> Tf abovz does not apply;foqow guidelines below:
<br /> I. CUNTCtACT�RCC� '�is 1.25%of contrack price with a(Minimum�ee ot$50.00)
<br /> `T��� x.0125$ `J ��r
<br /> (contract price) (miaimum 530.00)
<br /> 2. STAT�SC1CtC1�CAEtGE n 2��_
<br /> x.0005 $ L�
<br /> (COntr2Ct priCe)
<br /> 3. POSTAGE&C�ANDLING(Only on Mail-ln Applications) $ 2.40
<br /> 4. TOTAC,��RMIT���(Add�.ines 1-3 Above) S
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<br /> • * CONTitACT pTZYC�or .TOB COST means the actual or estimated dollar amount charged for the '
<br /> permitted work including materials,labor,profit,and other fixed costs. Tt is the amount ro be charged !
<br /> to the customer fflr the work done. yf any material,equfpment, labor or installations are furnish�d 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. ln thz event that there is a disputz on the
<br /> amount of the job cost,the City may request the submission of a signed copy of the actual contract.
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<br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do ell
<br /> work in strict accordance with the ord'snances of the City and the regutations of the State of
<br /> ivlinnesota, and certifies that all statements made pn this application ar� complete, uue and
<br /> correct.
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<br /> Applicant's Signature: .. ate: � �(J /
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