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. � � . - , :PERIVIIT CAL �'�ION�S _ - ,., ,,. <br /> ��, GIT� (.) <br /> . , B�SEI�'OFF;- ,, . ,;.�' <br /> 2�,Q�.�S�.A'TE S�`:�T`U:E <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 elecirical 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 $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> PE ' . .�,:. �;� - ' ON(S}-'T(OBS'OVER$SOD:flO ' =:";�..k., ;. <br /> g,h�(I'I'`-�`F.E�C�I.�CtJL�T'T' <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE '"is 1.25%of contract price with a(Minimum Fee of$35.00) <br /> ��. <br /> ��1°�.0125$ <br /> � (contract price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$.50) <br /> x.0005 $ <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> ■ * CONTR.ACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor,profit, and other fuced 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 /> esi�iimated 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 /> ,` - - �I�EC�I�NIC�L�?E�IVIXT;AFPI;IC`�i'�`�t�N�AG�tE�'l�IEN�',- �'�� ' <br /> :N. � <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: Date: �— �lo `� <br /> 3 <br />