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ImIm <br /> 11 <br /> Q Yes,this section applies <br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements <br /> :. Y t.�s q x a <br /> h , 1 Does not require modification to electrical or gas service. <br /> 2.* Has a totalcost of$500.00 or less;excludine the cost of the fixture or appliance and <br /> r 3 Is <br /> improved,installed or replaced by the homeowner or licensed contractor <br /> { Aa{ <br /> Slap next section,if this applies,. Cost of Permtt sc <br /> $ 15 00 s <br /> State Surcharge - _ $ 50trtr�' <br /> t` S Mail In Fee(If Applicable)' $ 1 SD <br /> r <br /> x � Total Permit Fee <br /> A r} <br /> _ 7777777--777 75ME E <br /> wx�ss.1 <br /> - <br /> n <br /> If above does not apply-follow guidelines below ` <br /> x <br /> r <br /> 1 CONTRACT PRICE *is 1.25%of contract price with.a(Minimum Fee of$35 00) <br /> r <br /> x.0125$ ` <br /> (contract price) (minimum$35.00)^ ' <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$.50) <br /> x.0005 $ <br /> (contract price) (rrummum$ .50). <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <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 /> to the customer for the work done. If any material, equipment, labor or installations are famished 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 /> 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 /> Applicant's Signature: Date:_z—f o <br /> 3 <br />