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. � <br /> ; � _ � � �.� �� .�,� �. �,$ , <br /> . ; � <br /> . - �,.: . r . :_ , . .. _ ._. �.: .�.... ��,,,QZ � ,: ... . � . . ...,;.. �; <br /> _ , . .:. :�. .�. .. <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 tota.l cost of$500.00 or Iess;excludine the cost of the fiacture 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 /> 1;4��.;t`�iY<'Y.kk,Y?���� � j ,���.I� �.�� ����j�l� �x ���� ir.�i'' h�s„'.��M^�'ji.;�MV�NI�'i'.drT�:j'�'�t��§y,G <br /> If above does not apply; follow guidelines below: <br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00) <br /> � ���135 -ob x.oi2s$ 12{� .b � <br /> (contract price) � (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$.50) <br /> �10, 13S�ao X.000s $ S . �'� <br /> (contract price) (minimum$ .SOj <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above} $ �33' Z� <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 /> estimated cost 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 /> ■ **The STATE SURCHARGE is.0005 of the Building Deparhnent at(952)249-4600 for the price. <br /> n,��_,'�����',�_,,`�� ,�1V�;,F1� t�C ���'� �' � 1�CA (� �;.�4,C'r, ' � � ;" � � ��:;����34�e:���� <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 /> c I <br /> Applicant's Signature: ' `� Date: � Z8 C�_ <br /> C11—� <br /> �-t a r � k t � na- i u�r:a,� e i <br /> "�..xi i.�i,y�-1 . '.'�p+ , <br /> � �f Mt }�-�'� ^�� � <br /> k f; i����s-�`��RESB���f���,� ���� <br /> (: �r�:�� ' *�.", �P:�._s4.�.����s::��'�:. ._, <br /> 3 <br />