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K <br /> ' �'ER]�I�' F�� ��4.�.,CL1�.A'�'IOl\'(S} <br /> 2002 State Statute ❑ Y�s �'his �eediora�pgj,es <br /> i h�replacen�ent of a Residential fixture ar apl�liance that meeis all three of the following rec�uirezncnts: <br /> 1) Does not require modification to electrical or gas service. <br /> Z) Has a total cost of 9>500.00 or less; excludin� the cost of the fixture or ap�iiance: <br /> and <br /> 3) Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip next section, Cost of Permit $ I5.00 <br /> State Surcharge $ .50 <br /> Nail-In Fee $ 1.50 <br /> If above does not apply, follo�h�guidelincs below: <br /> 1. Cota�ract I'a•a�e� ;s .0125°io of jab vait� a 1�✓k.pni��urn �+ec o�'(�35 f�0) <br /> �`���'�'� x .0125 � ;5�'S t��s <br /> (contract price) (minimurn$35.00) <br /> 2. State �urcl�ar�e. **Add the State Buildin�Code Division a 1'�fiin�rnum �'ee of($ 5�} <br /> _ L1� �� x .0005 $ . �.� <br /> (conCract price) (minimum n .50) <br /> 3. Pos�aQe and �andlir�� (C1taI}��aa�aal-ira ap�liccations) q� <br /> � ���� <br /> 4. �'�'���. �������`�' �"�� (Add lines 1-3 above) $ ,�5�},— <br /> *CO?tiTRP,CT PRICE or.IOB COST means the act«a1 or estimated doliar amoun�charged for the permitted worlc inr.ludin� <br /> materials,tabor,profit,and other fixed costs.It is thc an��oimt to bc charged to the cuslomer for tl�e v✓oric done.If any mater-�al, <br /> equipment, labor,or installation is furni�hed by the owner,tcnant or any other party the reasonable market value of such items <br /> rnust be added to tne estimated cost or contracC price for permit Cee purposes. [n the evenC that Yhere is a dispute on the a�naunt�f <br /> the job cost,the City may request the submission oi a signed copy of the actual contract. <br /> **Th�STA"I'E SURCI-IARGE is.U005 of the contract price under$1,OOU,000 or 5.50-whichever is greater. For valuaYions over <br /> $I,000,000 call the Department of Inspectional Services for the price. <br /> The undersigned hereby applies to the City for issuance of a Mechanical Pern�it,agrees to do all work in strict accordance with <br /> the ordinances of the City and the regulations of the Minnesota State I3uilding Code,and certifies[hat all statcments made on tllis <br /> appiication are complete,true and co ct. <br /> Applicant's Signature: /� ;, , cv Date: __ � /y"-os <br /> Approved By: Date: <br /> 3 <br />