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<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;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 Permit $ 15.00
<br /> State Surcharge $ .50
<br /> Mail-In Fee(If Applicable) $ 1.50
<br /> Total Permit Fee $
<br /> � � _ '.�'� ���ERIl�TI� -EEfC�CLTI:�iTI =S _��b���VER°$54U�D,�X`'`.��`lK�;���
<br /> If above does not apply;follow guidelines below:
<br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00)
<br /> �� / �� X.oi2s$ / �'�,1�
<br /> (L��ntract 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) $ � I o • �O
<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 fumished by
<br /> the owner,tenant or any other party,the reasonable mazket 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 Department at(952)249-4600 for the price.
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<br /> `�"'��'�•��`�° '��1VIEC�NICAL',PERMIT�ApPLICATION"AGREEMENT " .
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<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 cert' es that all statements made on this application are complete, true and
<br /> correct.
<br /> Applicant's Signatur . Date: �J_
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