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. <br /> �-, .. ��;� # <br /> �� � � <br /> ' y� � �-t .��,r ' �, ���� �_s� :�� .g. :�+�' a"*s� �' _ ��-"�s <br /> ✓"` ��'` ay,�s"`�,`t=� ;�; - r ' � i'..,, <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or annliance 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 fiM.ure 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) $ 2.00 <br /> Total Permit Fee $ <br /> _ . _ o.. ,�..,. <br /> � " ����� ,,� .n . .:. ... .,.- ::, ` _;�, ' ���'� ����,.k� �_. <br /> �� - <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fe $50.00) <br /> � � x.0125$ .4 <br /> (contract price) (minimum SSo.00) <br /> 2. STATE SURCHARGE "Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50) <br /> � x.0005 $_��_f� <br /> (contract price (mmunum S .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ - � <br /> ■ ' CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> peimitted 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 Deparhnent at(952)249-4600 for the price. <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do a11 <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 �s application are complete, true and <br /> correct. <br /> � <br /> Applicant's Signature GB�te� � �J f C� <br /> t�'Pµ � ��� I i�. �' t <br /> 3 `I - <br /> �v'ra":a� k�',rr<�mas��,x.,�z'�s��.-�,. <br /> --......,_�._..,:,._1.._z...,:.,._-s..,«....-.�....:-.-�...�,s.e,_.,-. <br /> 3 <br />