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L ' <br /> �'>.. � <br /> � , . � � <br /> Yc' } xC: <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 $ I5.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> ����.'������w�P�RIVIITr��E:CAI;CiJL'�A'PIOl�I S �':'k�OBS:�'VER$S�U�00��'���'�i ' � <br /> fi <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 /> fld ,/ <br /> ��Q � x.0125 $ `f�D. �-- <br /> onvact price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of 5.50) <br /> �JCp tJtJ�J,� x.0005 $ � v• v� <br /> contract price) (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � lJ�� • � <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 market value of such items must be added to the <br /> estimated cost or contract price for permit fee putposes. 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 /> ; ` ,�������._:MECHAI�ICAL`•PERMIT�APPLICATION."AGREEIVIENT:�. . � � '`° <br /> wr= �r f <<+ � r - <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 m e n this application are complete, true and <br /> correct. <br /> ApplicanYs Signature: Date: ����LD <br /> ti� �-�� � +er�a� n � �q.. rr�� <br /> , .s ,'.t� {N'V 1. • <br /> %.���Reset Form'�-� � � �; � <br /> ��� » , <br /> .. _. ...1't.t$� :'.u_:�,:..xr�.,°....'�:' �S � <br />