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, � , � <br /> ���Tt��E+��L�t�.,��N�� <br /> �ASE�E3�F�2C�Q��T�"�5'��'T� <br /> ❑ Yes,this section applies <br /> The replacement of a Residentiai fixture or appliance that meets all three of the following requirements: <br /> 1. Does not require modificarion to electrical or gas service. <br /> 2. Has a t 1 ost of$540.00 or less;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) S 1.50 <br /> Total Permft Fee $ <br /> PEI�MiT�E�:�LC�t��+�� S �3(���E���$��ktl� <br /> If above dces not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$35.011) <br /> IVV�• �� x.0125$ <br /> (coavact price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Swchazge(Minimum Fce of$.SO) <br /> x.0005 $ <br /> (coMtact price) (minimum S so) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 _ <br /> 4. TOTAL PERNIIT FEE(Add Lines 1-3 Above) S <br /> ■ * CONTRACT PRICE or JOB COST means the achaal 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 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 Department at(952)249-4600 for the price. <br /> .1����AfL�'�R�T%��'�:���"�flA�:��R.���F:N�' ;, . <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 /> ApplicanYs Signature: Date: -- �� —u� <br /> ' �.�+�rnt <br /> _ 3 <br />