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• I <br /> I <br /> i <br /> r <br /> '[ <br /> �r� ` <br /> � a,' � <br /> Yes,this section applies <br /> e repiacement of a Residentiel fiixture or appliar�ce that maets all thrae of the following reyuiremertts: <br /> 1. ces not require modification to electrical or gas service. <br /> 2. Has a total c s of$500.00 or less; excluding the cosi of the fixture ar a{�pliance:and <br /> 3. Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip next sectian,if this applies; Cost of�Permit $ 15.D0 <br /> State Swcharge �^ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.Ob <br /> Total Permit Fee � <br /> � �x� a. <br /> If above does not appty;follow guidelines below: <br /> 1. CONTRACT PRICE "is],25%of contract price with a(Minimum Fee of$50.00) <br /> �Of�. � x.0125$ � �5�.� <br /> i _ <br /> (condact price) (meeiroom$5U.00) <br /> 2. ST�iTE STJRCHARGE <br /> �P�. � x.0005 $ ,�, '7�� <br /> (corrtract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 � <br /> � <br /> 4. 'POTAL PERMTT FEE(Add Lines 1-3 Above) S S� ` �1 I <br /> � * CONTR.ACT PRICE or TOB CdST 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 ba charged <br /> , to the customer for the work done. If any material, aquipment, labor or instaliations ai*e furnished by <br /> the owner,tenant or any other parhy, the reasonable markei value of sucU items must be added to the <br /> � estimated cast 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 /> ��. <br /> T e undersigned hereby applies to the �ity for issuance of a Mechanical Permit, agrees Co do sll <br /> w rk in strict accordance with the ordinances of the �City and the regulations of the State of <br /> innesota, and certifi�s that all statements made on this applicadon are complete, true and <br /> c rrect. <br /> plicant's Signature� � �._� Date: �/S�f� _ <br /> 3 <br /> � 'd Xd� 13C213Sd1 dH WdZO � T STOz SO �eW <br />