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. - � <br /> r ' <br /> �. CE��T�.�����L���T�����?�' �` . . <br /> ' BA����J�F-�Q�}2 STATE STA'�UE <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 modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 ar 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 section,if this applies; Cost of Pennit $ I5.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> FERMIT'�EE��r�A"T�C�N � -308��3VEI�$SQU.Ot� <br /> If above does not apply;follow guidelines below: <br /> l. CONTRACT PRICE * is 1.2�of contract price with a(Minimum Fee of$35.Of!) <br /> �� <br /> � x .0125 $ � � <br /> ( ntractprice) � (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fe of$.50) <br /> Od �i� <br /> � X.000s $ , � <br /> contrac pricef (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> oa <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 material, equipment, labor or installations are fumished by <br /> the owner, tenant or any other pariy, 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 ofthe Building Department at(952)249-4600 for the price. <br /> MECHANI�A�PE�'�"'A�'PLi�ATION AGI���EI�T <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 �nade on this application are complete, true and <br /> correct. <br /> Applicant's Signature: Date: p� � D <br /> Reset F+or`r� • • <br /> 3 1 <br />