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� <br /> ❑ Yes,this section applies <br /> T'he replacement of a�tesidential fixhue ar anvlia�e tl�at rneets all mree of the following requirements: <br /> i. Does not require modification to elec#ricai oa�gas seavice. <br /> 2. Has a total oost of SSW.00 or less;ex " tlae cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the t�omeowner or licensed contracbor. <br /> Skip next section,if ttris applies; Cost of Permii S 15•W <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicabie) $ 1.50 <br /> Tota!Permit Fee S <br /> If above dces not apply,follow guidelines below: <br /> 1. COi�1TRACT PRICE •is 1.25%of co�tract price with a(11�imnm Fee of$35.00) <br /> 3��-a��� xA125S <br /> (co�Pticx) (minimwn 535.00) <br /> 2. STATE SURCHARGE **Add i�e State Bldg Code Div.S�chatge(11�n�um Fee of 5.50) <br /> x.0005 $ <br /> (ct��P�x) (min;mnums .so) <br /> 3. POSTAGE&HA1vllLING(Only on Mail-In Applications} $ 1.SQ <br /> 4. TOTAL PERMiT�E(Add L'mes 1-3 Above) S <br /> • *' CONTRACT PRICE or JOB COST m�ns the actual or estinnate�dollar amount charged for the <br /> perntitted work including maRerials,labar,Profit,and oth�'fixed costs. Ii is tl�re emouirt to be charged <br /> to the customer for the woork do�. If anY material,equiPcnent,labor or installatiarns are fiunished by <br /> the ow�r,tenant or any other party>the reasonable marke.t value of such ite,ms mt�st be added to the , <br /> es�timated cost or conh'act price for petmit f�purposas. In the event that thete is a dispute on the <br /> amount of the job cost,the Ciiy may request the submission of a sig�ed copy of ti�e actual contract. <br /> ■ '*The STATE SURCHARGE is.0005 of the Buiiding Depac�e�t at(9523 249-4600 for the price. <br /> The andersigned hereby applies to the City for is.�ance of a Mecbanical Perm�it,agcees to do all <br /> work in strict accflrdance widi the ordinances of the Ciiy and tl�e regulations of the State of <br /> Minnesota, and certifies that all statements made on d►is application are complete, ttue and <br /> correct. <br /> Applicant's signature: � Date: l 0 a-b 6S� <br /> . a � t <br /> � <br /> . � .. 3 <br />