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t , . <br /> M <br /> + ,��:�� � �,y�` `����� ���� ' �P��I'�FLE CA��;�A,�TTt��1(5��,� � ��i ; � ���;,, '�: � ��t. <br /> ; n �^'. (� �}*�` <br /> 1 . -b�. ,, i�� ,..f , ��� 7J�� Q�1'.;�.'��0������17��1 4.J��. �i... S t�- , i°i�. <br /> * f � % <br /> 3n..��r .. ,xi . �....- . .. .,.. .r.. . ..a . . <br /> ❑ Yes,this section applies <br /> The replacement of a Residenrial 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;excludin�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 Pernvt $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> ; Total Permit Fee $ <br /> ` ` .�_ �PER�ViIT=�EEE C,ALCULATION(S};,=>JpBS OVER.$SQ0.40'; ; t � ,. ..;� <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$35.00) <br /> � /J 60o X.oi2s$ /v S�ov <br /> (contract price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of 5.50) <br /> j � 6C�t� x.0005 $ S. g0 <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) $ �� • S D <br /> ■ * CONTRACT PRICE or JOB COST means the actual or esrimated dollar amount charged for the <br /> pernutted 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 party, the reasonable market value of such items must be added to the <br /> estimated cost or contract price for permit fee pwposes. 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 /> °, ' '" 1VfECHANIGAL'PERMIT APPI;ICATIQN AGREEMENT . <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 /> � <br /> Applicant's Signature: ����� Date: S ��/o� <br /> 3 <br />