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, <br /> j i� 3 E �������E # ' . <br /> .,�` ��� ���o-� ���, .�+� ��"�.�t?�� E , � <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance that meets aU three of the following re�uirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance:and <br /> 3. ls improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip next section,if this applies; Cost of Pennit $ l 5.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ t.50 <br /> Total Permit Fee $ <br /> ';6? �U=�� �':�!! +; .� '� ��lv —:���� ` � i t# ,.; <br /> ������; � ���" .�',. �? ' �xC..�'.t=. �. <br /> If lbove does not apply; follow guidelines below: <br /> i. CONTRACT PWCE * is 1.25%of contract price with a(Minimum Fee of$35.00) <br /> � �/ �� <br /> �. OD ) , X.o�25$ D <br /> ( ontrlct price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bidg Code Div. Surcharge(Mini um Fee of$.50) <br /> � � be ��-� °.� <br /> X .000s $ <br /> ( ntract price) (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> G�0 <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 �naterial, 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 /> lmount of the.job cost, the City may request the submission of a signed copy of the actual contract. <br /> ■ **The S'fATE SURCHARGE is.0005 of the Building Department at(952)249-4600 for the price. <br /> ..'�.��",.I���i+��_ � ` �,�: , ��. �?ETIO�#r���'�ss�i ' <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do a!1 <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, 111CI certifies that all statements made on this application are complete, true and <br /> correct. <br /> Applicant's Signature. � _ Date:_ � � <br /> .,�p�� 3��'t{.��' � � <br /> . .. 3 <br />