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� <br /> � v <br /> � . � <br /> ` ,• � `� a� - �. � � <br /> �� < f�5� ��. ,� rr ' �. fi � ' ' � <br /> �.r Y"9a�i .,�yY � -,<�'G'7�r�a`�„��,�x � �� +r�.�p° �ya� , t <br /> . �-Pq�''�,�`�i�,� �'��'�?S) x'"`a'i��,�:`k r,s�. ..3ti�.:� �.'s s i '� ,F�, z�"e �'r a� �'.�n bi.�,�$ �,1 <br /> #h. #,r <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> 1. Does not require modificarion 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. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip next secrion,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> . . � }3 3�;�.k� k±�.fi{i: � e'�.Y� �r��'„�� � �...�.�`<�,+����!:i. �� l:������������'�1/��`'.��1 z�l. ,�'J i`P `� � " <br /> � <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25°/a of contract price with a(Minimum Fee of$35.00) <br /> �Q� � x.0125$ <br /> (contract price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of 5.50) <br /> x.0005 $ <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> ■ * CONTRACT PRICE or JOB COST means the actual or esrimated 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 <br /> estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the <br /> amount of the job cost, the City may request the submission of a signed copy of the actual contract. <br /> ■ **The STATE SURCHARGE is .0005 of the Building Department at(952)249-4600 for the price. <br /> ' . �. . .:i MEC�TA.I*�I�.�^L-{P:ER,MIT A;FPLI�A'FT4�T AG�2EElV1���' �� <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 /> ' � / <br /> Applicant s Signature: � �/�� Date: � 6 <br /> 3 <br />