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� <br /> ,� <br /> � .p��C����C�Cu���ro�.�rfis� ,- �� A °�� ,�{i€, . ��� ,r <br /> r f� � �.. ' �BASED OF� -`2UO2 S'�"ATE�`�A �': <br /> � ; <br /> � r <br /> ' � � "' z 3p , �3 <br /> ..� �� e •� `� +� ,' <br /> I �' <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 or less;excludins 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 Permit $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> " = �PERMIT FEE,CALCLTLATION S) ''=�JOBS 4VER$500:00 �, <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$35.00) <br /> x.0125$ <br /> (contract price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.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 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 furnished by <br /> the owner,tenant or any other party, the reasonable market value of such items must be added to the <br /> esrimated cost or contract price for perniit 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 /> 1VIECHATTICAI;PERMIT APPLICATION AGREENlENT <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 /> conect. <br /> �� � ., r— <br /> Applicant's Signature:� C�°`�"`—Date: S � I J "� `� <br /> 3 <br />