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, <br /> .� . <br /> • .: , , . . , a : , . . <br /> 1�����'..� � � ,.� ' <br /> ��`��•.��`#��*�`�'�� ,, . <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixbue or agpliance that meets all�of the following requirements: <br /> 1. I�es not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the hom�wner or licensed contractor. <br /> Skip ne�section,if this applies; Cost of Permit $ �0'— <br /> State Surcharge $ �ff" <br /> Mail-In Fee(If Applicable) $ �— <br /> Total Permit Fee �� <br /> PE�IIT�����,��i'T� � ::--�Q���!E��Si�i3,08. <br /> If above dces not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of conta�act price with a(Minimum Fee of$50.00) <br /> � ��1�/� x.0125$ � �o7s-� <br /> (contr�t price) (minimam 559.00) <br /> 2. STATE SURCHARGE *'`Add the State Bldg Code Div.Swchatge(Minimum Fee of 55.00) <br /> � /!�,vll� x.0005 $�g S W <br /> (contract price) (miAima�S 5.00) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) � 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S� l3 a.� <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollaz 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 /> estimate� 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 STAT'E SURCHARGE is.0005 times the Contract Price or a minimum of$5.00. <br /> .. :_� �������������� �'� � . , �.,j� �'. �,' .', <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 cerrifies that all statements made on this application are complete, true and <br /> conect. <br /> ApplicanYs Signature: �== Date:�D l,� _ <br /> / <br /> R�'t i��. 3 <br />