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10/07/2015 09:10 6517722440 STANDARD HEATING PAGE 03/03 <br /> E] Yes,this section applies <br /> The replacement of a Residential fixture or applimce that meets all three of the following requirements: <br /> 1. Does no require modification to electrical or gas service. <br /> 2. Has a total c of$500.00 or less;excluding 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 $ 1.0 <br /> Mail-In Pee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE 'r is 1.25°/a of •ontrac price with a(Minimum fee of$50.00) <br /> O x.0125$ / <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCLIARGE (0 — f <br /> x.0005 $ <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2. <br /> 4. TOTAL PERMIT FEE(Add Dines 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 /> to the customer for the work done. If any material,equipment, labor or installations arc fumislted 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 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. l <br /> Applicant's s SignatureC)rv�C-Vl-7ate! / <br /> 3 <br />