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i,;M:,-15-Zk2 'I:30am From-t.lTY lir uxuirta r°„L.,,,,,v"' - - <br /> • <br /> U MMI' C c` L n-A'X'liC9)atil <br /> 2Q02 state ut Pi 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 modifIc tiort to electrical or gas service. <br /> 2) Has a uituij of$500.00 or less;excluding the cost of the fixture or appliance: <br /> and <br /> 3) Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip next section; Cost of Permit $ 15.00 . <br /> State Surcharge$ .50 <br /> Mail-In Fee $ 1.50 <br /> If above does not apply, follow guidelines below: <br /> 1. Cnntrgctyrice*is .0125% of job with a Minimum Fee of($ 59O) <br /> 415Vd.1 x.0125 $ : .2 c, <br /> (contract pricy) (tr.inima:rn$35.40) <br /> 2. State Surcharge-**Add the State Building Code Division a iV iniummFee ofij_501 <br /> x .0005 $ :<' 5_(contract price) (minimum$.50) <br /> 3. Postage and Handling(Only mail-in applications) <br /> S 1.50 <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ &O t <br /> *CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including <br /> materials;labor,profit,and other fixed costs.It is the amount to be charged to the customer for the work done. if any material, <br /> equipment.labor,or installation is furnished by the owner,tenant or any other party the reasonable market value of such items <br /> must be added to the estimated cost or contract price for permit fee purposes.In the event that there is a dispt.te on the amount of <br /> the job cost,the City may request the submission of a signed copy of the actual contract, <br /> **The STATE SURCHARGE.is•.3005 of the contract price under$1,000,000 or$,50-whichever is greaser.For valuations over <br /> $1,000.000 call the Department of Inspectional Services for the price, <br /> The undersigned hereby applies to the City tot issuance of a Mechanical Permit,agrees to do all work in strict accordance w'.th <br /> the ordinances of the City and the regulations of the Minnesoi:,State Building Cade,and certifies that all statements made on this <br /> application are complete,true and correct. <br /> .Applicant's Signature:_ .a1 �( k� Date; 6/Jo9 ____ <br /> Approved By: Date: <br /> 3 <br />