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04-14-'15 16:06 FROM- T-722 P0003/0004 F-886 <br /> �.. f. �li�� ,. �!i: . +SJ K• �b ' .s <br /> M-i�f2 '�. rldmu y <br /> Yes,this section applies <br /> i <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;excludin 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 $ 5.00 <br /> Mail-In Fee(1f Applicable) $ 2.00 <br /> Total Permit Fee <br /> � % +i Na.4 .,', Ye1�F.�Go >-�.�ar".:;ixw' <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50,00) <br /> `4 U`'I o X.0125$ 58 c) <br /> (contract price) (mioilmum 550.00) <br /> 2. STATE SURCHARGE ' r { I c <br /> 0005 $ <br /> ` . <br /> x <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add sines 1-3 Above) S <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 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 /> i <br /> i <br /> •i, ' <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 1 <br /> correct. <br /> Applicant's Signature: Date: 1 <br /> 3 <br />