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1 <br /> r � � <br /> ' , � . !'.Li��,[ �T���Z'Y1.r,L,/�t�.�P�.t�l33.Y{.7� .,, . - � <br /> ,. . . L71'l�La���1:' "L.�VL rJ I��1.'i����.L tJ�+' � � ,. <br /> es,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;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 Surchazge $ 5.00 <br /> Mail-In Fee(If Applicable) $ Z.00 <br /> Total Permit Fee $ <br /> PE�:M�'�'�'EE C��T.f L,�1'��'}N' � —�t�BS f3�'ER$5�3t}.� „ , <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> � l V�.J V x.0125$ <br /> (contract price) (minimum$50.00) <br /> Z. STATE SURCHARGE <br /> x.0005 $ <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollaz amount charged for the <br /> permitted work including materials,labor,profit,and other fixed costs. It is the amount to be cha.rged <br /> to the customer for the work done. If any material,equipment, labor or installations aze fumished 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 /> . � �EC;��.AN�CA.L PERM�T,A.�'`�''I.��A'�"Tf�����EIVIE�T' <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 sta.tements made on this application are complete, true and <br /> correct. <br /> Applicant's Signatur : Date: ,(}I�T`"L <br /> , _ -�@S��FCfi't�'t ---'i <br /> 3 <br />