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B-° 01:Y "4^` <br /> , '�� <br /> ® 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 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> 41444:, <br /> E MI tF iotuat l N(5 7Q QVE'® ( 4 re a <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 /> 7,200.00 x .0125 $ 90.00 <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee 01'5.50) <br /> 7,200.00 x.0005 $ 3.60 <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE& HANDLING (Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ 95.60 <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 /> • ** The STATE SURCHARGE is .0005 of the Building Department at(952)249-4600 for the price. <br /> PIAM,M - .l ..Ap'a: '476-70I-F Fi'r <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: &I'd-to ' %�-6c� Date: 03/31/10 <br /> PP`I S v ori'i1 <br /> 3 <br />