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t <br /> �'E���' �+E� �'1�k.,CLJI.�§,"&'ION(S) <br /> 2002 :�tat� �ta�ute ❑ `�'es 'I'his See�y�n�.ppties <br /> The replacement of a Residential fi�ture or appliance tllat ineets aIl three of the following requireznents: <br /> 1) Does not require modification to elecn-ica] or gas sen-ice. <br /> 2) Has a total cost.of 5��00.00 or less; excludin� the cost of the fixture or applrance: <br /> and <br /> 3) Is improved, installed or replaced by the hameo��zer or licensed contractor. <br /> Skip next section; Cost of Fennit $ 15.00 <br /> State Surcharge $ .50 <br /> I�,'Iail-In Fee $ 1.50 <br /> If above does not apply, folIo«�guidelines below: <br /> �. �'r�r���-�ct�'�-i�e�� is .0125°io o;job v✓it11 a��p��cn�um ��ee of(�3�.00) <br /> �����:� .� .0125 � :5� � <br /> (contract price) (minimum�35.00) <br /> 2. �tat� ��r�har�e. ** Add the State Buildizlg Code Divisior.�.a 1`�ia�gmum �'ee of(n 50) <br /> ' ��; � .00�� � _ .l� <br /> (cont�ract price) (minimum n .50) <br /> 3. �os�aQe a�zt� ���nc�ii�a�(�tady�Barril-ira ccp�Iieati.o�rs� �; ���.-' <br /> 4. '�'�'�'��, ������1 �'�� (Add lines 1-? abo��e) $ s�/(o�, <br /> *CO;�TRACT PRICF�o;JOE3 COST means the actual or estimated oollar amoitnf:charged for the pennitted u�orl:including <br /> materials,labor,pront,and other fixed costs. Tt is the�amount to bc cl�areed Yo the customer for the�vorl;done. If any material, <br /> equipmenf,labor,or ir�stallation is fu�;�ished by thc owncr,tenant:oi any other party the reasondble market value of suct� items <br /> must be added fo the estimated cost or contraet price for pemiiC tee purposes. ]n the evenl tnat t�here is a dispute on the amount o` <br /> thejob cost,the Cit}'r1�ay request�the submission of a signed copy of the acCual contract. <br /> *�"I'he STATL;SURCI-IARGG is.0005 of th�contrar,t price under�1,000;000 or�.50-whichever is greatcr. For valuations ovee <br /> �1,000,000 call the Department of Inspectional Services for the price. <br /> The undersigned hereby applies to the City for issuance of a Mechanical Pennit,agrees to do al]worl<in strict accordance with <br /> Yhe ordinances of the City and thc reguiations o;the Minnesota State L'uilding Code,and certifies that al]statemerits�tiade oi;this <br /> application are complete,true and c� ct. <br /> Applicant`s Sie ature: � w ��,,-% {�-L Date: �- ��-��� <br /> Approved By: Date: <br /> 3 <br />