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f k <br /> � r <br /> .,f, x r�a .E f-Q �� .����t��C���`���y?j��l�l`7��� i N,��� �-w`.,�• `�krA`a �.��},''�y.F.��(fd �b� <br /> � s` ; 2'�B • ;�� � 3m lL n i tD.` rc�9F-�4" <br /> 0 .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;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 r ` . <br /> }' n State Surcharge • , <br /> t <br /> Mail In Fee(If Applicable) • $ 1 50 <br /> Total Permit Fee $ <br /> If above does not apply;follow guidelines below. <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$35.00) <br /> : J c x.0125$ �.' <br /> tract <br /> ('Aprice)P •. (minimum$35.00) x <br /> • 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge (Minimum Fee of$.50) <br /> x.0005 $ <br /> (contract price) (minimum S .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 furnished by V <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 /> g1 CA PER1V1 I`A LTCATrO 1EEIVtEl � <br /> The undersigned hereby applies to the City for issuance of a Mechanical Pert, agrees to do all <br /> work in strict accordance with the ordinances of the City and the regulatimions of the State of <br /> Minnesota, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> /111111' /r- <br /> Applicant's Signature: —� Date: <br /> • <br /> 3 <br />