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♦ 'I ` <br /> : (: ��' � ��������.�i 1a��������J���� � - 3 . <br /> . ,� .. �� ,,'.�������['. ����t�' ����,.,,,�,,,,J, 1� ,�'�,L'','�,✓''i. "::'�: i3-s�,f�m.. . <br /> � „ � i <br /> � ❑ Yes,this section applies <br /> II The replacement of a Residential fixture or apnliance that meets all three of the following requirements: <br /> i <br /> � 1. Does not require modification to electrical or gas service. <br /> ! 2. Has a total cost of$500.00 or less;excludin¢the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> I <br /> I <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> I State Surchazge $ .50 <br /> � Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> r ����� �����:'�'�. '; �; <br /> ' , _,.,, � .. � �����������.�� , ;. :'`:: ' ,; , <br /> If above does not apply;follow guidelines below: <br /> � <br /> i 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00) <br /> �� 31,286.00 x.Ol 25$ 391.08 <br /> � (contract price) (minimum$35.00) <br /> I 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee ofS.50) <br /> I 31,286.00 x.0005 $ 15.64 <br /> i (contract price) (minimum$ .50) <br /> � �i 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> � <br /> 406.72 <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 /> � permitted work including materials, labor,profit,and other fixed costs. It is the amount to be charged <br /> I 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 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 /> < <br /> ' ����1���', ���+�'I'�'��.��'�'�N'AC`'t����N'T` <br /> ,, <br /> I he undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> i ork in strict accordance with the ordinances of the City and the regulations of the State of <br /> innesota, and certifies that all statements made on this application are complete, true and <br /> rrect. <br /> 09/o2/O8 <br /> � plicant's Signature: Date: <br /> ����, �.� � R��r��k�+��an �,. �.. <br /> i <br /> 3 <br /> I <br />