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�. <br /> � <br /> ❑ Y es,this section appaics <br /> The replacement of a$esidenrial fixtuKc or app1iaz�ce that meets atl three of tkae following requircments: <br /> 1. cs not re�uare modificatliot�to cicctrical o1r gas service_ <br /> 2. Has a total cost of$�OOAO or less; cludi the cosC of the fixm;re or appliance:and <br /> 3. Is impxoved,installed or zeplaccd by t}ae homcowner oc lieetiscd contractor. <br /> Skip next sectian,l�t�i8 applFeS; Cost of�ezx�it $�,�.00 <br /> SfRtc Surc�taz�ge $ 5.00 <br /> Ma11-In Fee(��A,p�licable) $ z.ao <br /> �'ot�l Permit Fee $ <br /> � <br /> Xf abovc does t�ot�pply;fol�ow guidelines below: <br /> 1. CONTRACT PRICE *as 1.25%of couUract price with a(IVxfnimum Fee of 550.00) <br /> s� <br /> — �.��3 �� x.0125� �� <br /> (contracE price) (minimum SS0-00) <br /> 2. STAT�SURCHAItG� <br /> x.0005 S, <br /> (con2xact price) <br /> 3. P057"ACr�&HAIVDL�TG(Only on Mail-Zz�,A,ppli�ations) $ 2,00_ <br /> 4. '�'OTAL PE���'FEE(Add Lines 1-3 Above) $ <br /> • '" CONTRAC'�' PktICE or JO� COST means the actual or estimated dollar am,ou�t �harged for the <br /> pe�t�itted work in,c�udattg materials, �abot,�rofit, and otber fixed costs. �t is thc amourlt to bc charged <br /> tn the custozner for the wazk done. If any maCetial, equiprqep,t, labor or insrallatxoas are fur�ished by <br /> the owner,te�,a.ut or any other paxty, thc rcasonable xnarkct value of sueh items�;ust be added to tbe <br /> estixr►ate(1 cost or cq�,tract.�rice for peetzl'tC fe�purposes. In the evept t(�a[ thcre is a dzspute on the <br /> amount of the job cos� the City niay request the submission o�a signed copy of thc actual cot�itact. <br /> 'The uzadersigned hereby applies to tk�e City for issua�ce of a MecXaanical Pem�� agrees to do all <br /> woz'�C in striet accordance witb, the ordinataces of the C�ry and the regulations of t�e State of <br /> Mimlesota, and certifics that all statcments made oz� tk�is applicat�orz are comp�ete, true and <br /> correct. <br /> A��licant's 5ig�oature: � � Date: "'��`"� <br /> o. �. � <br /> 3 <br />