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. , <br /> - - �PER1�T.�'EE.C.�:�;,�L1�;,,�1,.1"�,.N{�) ,, <br /> , -B1�SED�}l�-24Q� �T.AT'�?-5'��."�'�.1� <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or annliar►ce 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 Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> �'EF�'T'���.��.�t.�..l�.�'T()�1 � =JC}BS t�VV�i�. 5f�.t�l . <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$35.00) <br /> �-�7 � x.0125$ � • w <br /> (contract price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$.50) <br /> � Z � � x.0005 $ <br /> (coniract price) (minimum$ .5 ) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � <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 reyuest 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 /> �;; . . ' ;l�C���t��.L.�' 'R�II�"'�! '�"Ii�'� �F��r.1��`�' .. <br /> ��. �. <br /> T'he 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 Sign re: Date: � b� <br /> , �., , ��!���� S ji�$� ��: <br /> .�• �.. �t:�',•_ ' <br /> � , <br /> . ,, i ;���,' ,?�;• <br /> .......:..�a..,,,.,..._._____„....�.,....J......... . •... ...,.,..e.�..x..::i...? <br /> 3 <br />