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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 total cost of$500.00 or less;excludinu 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.�
<br /> State Surcharge $ .50
<br /> Mail-In Fee(If Applicable) $ 1.50
<br /> Total Permit Fee $
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<br /> If above does not apply;follow guidelines below:
<br /> 1. CONTRACT PRICE 'is 1.25%of conlract price with a(Minimum Fee of$35.0(1)
<br /> �� �� � x.0125$ ����
<br /> (conhact price) (min'vnum�i5.0o)
<br /> 2. STATE SURCIiARGE ••Add the State Bldg Code Div.Surcharge(Minimum Fee of$.50)
<br /> �1 S�O i x.000s $ c� �.S
<br /> (contracr price) cminimmn S .so)
<br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
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<br /> 4. TOTAL PERNIIT FEE(Add Lines 1-3 Above) $ �o
<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 fiunished by
<br /> the owner,tenant or any other parly,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 tbe job cost,the City may request the submission of a signed copy of the actual contract.
<br /> ■ **The cTATE SURCHARGE is.0005 of the Building Deparhnent a�(952)249-4600 for the price.
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<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 /> COrteCt.
<br /> Applicant's Signa . Date: � J f VJ
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