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<br /> ❑ Yes,ihis section applies
<br /> The replaceir�ent of a Resid�►tigl fixture or ac�uli�that meets all three of the foliowin,g requirements:
<br /> 1. Do n t require modification to electrical or gas service.
<br /> 2. Has a xotal cost of$500.00 or less;gxcludins the cost of the 8xture 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 Permit $ lg•00
<br /> State Surcharge $ .50
<br /> Mail-In Fee(If Applicable) � 1,50
<br /> Totai Permit Fee S
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<br /> If above dces not appty;follow guidelines below:
<br /> 1. CQNTRACT PRICE *is 1.25%of contract price witis a(Minimum Fee of 535.00)
<br /> 5,�.� x.0125$ 62.50
<br /> (conkact ptice) {minimutn$35.00)
<br /> 2. �TATE SURCHARGE •#Add�he State Bldg Code Div.Surcharge(Minimam Fee of 5.50)
<br /> S,OOo.bO x.0005 $ 2.50
<br /> (contract Price) (a�inanum S .50)
<br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $_ 1.50
<br /> 66.58
<br /> 4. TOTAL PERMIT FE�(Add Lines 1-3 Above) S
<br /> ■ " CONTRACT PRICE or JOB COST means tha actual or estimated dollar amount charged for the
<br /> permitted work including materials,labor,profit,and other fixed costs. It is ihe 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 party,the reasonable market value of such items must be added to the
<br /> estimated cost or contract price for pemvt fee purposes. In the event that there is a disgute on the
<br /> amount of the job cost,the City may request the submission of a signed copy of ihe actual contract.
<br /> ■ "`*The STATE SURCHARGE is,f�05 of the Building Department at(952)249-4600 for the price.
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<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 /> 12/OS/06
<br /> Applicant's Signature: ''t� Date:
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