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. <br /> �ER]��IT' FEL �AI.,C'i1L�4,'�'I(�N(Sl <br /> 2002 Stafe Stata�te ❑ Y�s 'Fhis �ee�ion�ippties <br /> The replacen�ent of a Residential�xture or a��iance that meets all three of the following requia�eznents: <br /> 1) Does not require modification to elecfical or gas service. <br /> 2) Has a total cost of S>500.00 or less; excludin� the cost of the fixture or applrance: <br /> and <br /> 3) Is improved, installed ar replaced by the homeowner ar licensed contractor. <br /> Skip ne�;t section; Cost of Pertnit $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee $ 1.50 <br /> If above does not apply, follo�u guidelines below: <br /> 1. �'on�raet I'a-ice* is .0125% of jab with 1 l��naanum 3�ee €�f(�'�5 00) <br /> � <br /> Z-�-��� x .0125 � ���'.�, <br /> (contract price) (minimum$35.00) <br /> 2. 5tate Surcl�arae. **A.dd the State Builcling Code Division a id'finimum Fee of($ 5�} <br /> ��Z�� a; x .0005 $ _ f �t� <br /> (contract price) (minimum$ .5O) <br /> 3. �'Qs�a�e an�l�audign� (�ta�A�aaac�il-c�a ca�ptacatiofr�s) � <br /> — —T�___..�, <br /> 4. �'�3�'�L, ��'���' �'�� (Add lines 1-3 abave) <br /> � --.�� <br /> *COivTRAC'P PRICE or.JOB COST me.ans the actual or estii;�ated dollar arnount char�ed for the permitted vaork inc]udin<.; <br /> materials,tabor,profit,and ether fixed costs. Tt is the amotmt to be charged to the custon�er for the rvor�done.If any material, <br /> equipment, labor,or installation is furnished Uy tPie o�vner,tenant or anv other party the reasonable marlcet valuc of such ilems <br /> must be added to tne estimated cost or contract}�rice for permit fee purposes. In Che event that Yhere is a dispute o�7 tl�e amount of <br /> thejob cost,the City may request the submis,ion oi a signed copy of the actual contract. <br /> **The STATE SURC]-fARGE is.0005 of the contract price under$I,OQU,000 or$.50-whichever is greater. Por valuations over <br /> �I,000,000 cail the Department of Inspectional Services for the price. <br /> The undersigned hereby applies to the City for issuance of a Mechanical Pemiit,agrees to do ali work in strict accordancc with <br /> the ordinances of the City and the regulations of the Ninnesota State Buildin�Code,and certifies that all statements madc on this <br /> application are complete,true and correct. <br /> Applicant's Signat �,�i,�, � <br /> . Date: ��� ,�L �_ <br /> Approved By: ' <br /> I�ate: <br /> 3 ' <br />