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12/11 2009 22:14 9529432653 #1500 P.003 /004 <br /> . <br /> �� 4 'r r �'���,n�� � <br /> � "'} rn <br /> 4.k�� t <br /> i,�,^G� r . � ! <br /> �. ,s+t <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 no require modiScation to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance: and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip neact section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> If a ve does not apply;follow guidelines below: <br /> i 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> 600.00 x.0125$ 50.00 <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE "*Add the State Bldg Code Div.5urchazge(Minirnum Fee of$.50) <br /> ___ , 600.00 x.0005 $ 0.50 <br /> (contract price) (minimum� .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In App(ications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 52.50 <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 installaYions 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 pwposes. 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)249-4600 for the price. <br /> Th undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> w k in strict accordance with the ordinances of the City and the regulations of the State of <br /> Mi esota, and certifies that all statements made on this application are complete, true and <br /> co ect. <br /> A licant's Signature: Date: 11/13/09 <br /> 3 <br />