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,. �. , <br /> �'E1��i`�'��E�����;��'�(,�1���): .. <br /> : ;BA����?�'F �Uf�2�'a�`�,�E�TP�T�,JE ' , <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;excludine 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 /> PE�`I`�EE:CALCLTLATIC7�T � -7t)BS C}�ER$540;:Qt} <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.0125 $ 2 2� <br /> (contract price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of 5.50) <br /> i� ��� x.0005 $ l <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Only on Mai!-In Applications) $ 1.50 <br /> 2 / <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � 7 � <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 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. <br /> 1�E+��IA�I�AL P�Rl�1�T APP�;��CATIUN A+Gi�EEMEIr�T <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 /> ��rt\ <br /> Applicant's Signature: v J" Date: l�'3—b� <br /> Reset��For,m�: > <br /> 3 <br />