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08/09/2007 09:05 FAX 9527587002 STASNEY MECH C�001/003
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<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 tal cos 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 con�ractor.
<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 /> If above does not apply; foUow guidelines below:
<br /> l. CUNTRACT PR10E '� is 1.25%of contract price with a(Minimum Fee of 535.00)
<br /> ��a� x.0125$ I��i'J �
<br /> (co Vact price) (minimum$35.00)
<br /> 2. STATE SURCHARGE ** Add the State Bidg Code Div. Surcharge(Minimum Fee ofS.50)
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<br /> a �3o X.000s $_ 6 3i
<br /> (co act price) (minimum S .50)
<br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $__ 1.50
<br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ /�js�
<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 vatue 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 STAT'E SURCHARGE is.0005 of the Building Department at(952)249-46U0 for the price.
<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, a.nd certifies that all statements made on this application are complete, true and �
<br /> correct.
<br /> Applicant's Signatur . Date: ���7'fJ7
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