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. PERtvt�'1'� ��� C<4L.C�:�LATI01�i{S) <br /> '��4:�E�r�f�k - �t�t�� STA't'� �TATUE <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;excludina the cost of the fixture or appliance:and <br /> 3. Is unproved,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 /> 'z:�� ..::t�#:::::«:>::;>;::::::s>:>:::::<:::>::::::::>::::::>:::::< <br /> ',;..;..��:�:'>:�:���:::����. . � <br /> `:<i<'>::����'::�::iG�:�:�J�i�� <br /> ::.::.:::::::.:.::::: <br /> :::::::::::::::::.:. <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE 'is 1.25°/o of contract price with a(Minimum Fee of$35.00) <br /> j � � � <br /> 1 ( QQ� x.0125$ ' � <br /> (contract price) (minimum$35.00) <br /> 2. STATE SURCHARGE *•Add the State Bldg Code Div. Surcharge(Minimum Fee of 5.50) <br /> �Cj � C�� x.0005 $ , )�� <br /> (cootract price) (minimum S .50) <br /> 3. POSTAGE&IIANDLING(Only on Mail-In Applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � 1 ,�. - ` )LJ' <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permittc�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 party,the reasonable market value of such items must be added to the <br /> estimated cost or contract price for permit fee ptuposes. 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 /> ■ s'The STATE SURCHARGE is.0005 of the Building Departrnent at(952)249-4600 for the price. <br /> >:::>::>::»::;:>�> :::>;::::>::::>:.>::>::>::::>;;..:. . .: . ;;:.;:::... ..:. . <br /> " ':.'`:::;:::<.::..; :.. .. :..:...:::,:.>....:`;;:;::::>.:>.::>>:> <br /> :;;:'::>::>:::<:::;::;:':>:::::::>:>::::;......��:�� `�:�'��l?�1`.,t�"F�,:������:,������'�':::>>.::>.;.;. > <br /> ........ <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 regularions of the State of <br /> Minnesota, and certifies that all statements made on this application are complete, riue and <br /> correct. <br /> Applicant's Signatur � ^ � Date: V� <br /> Rese�t�urrn <br /> _ 3 <br />