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� AL 'S MASTER PLMG 6128225408 05/18/05 0�:20pm P. 002 <br /> ��E�uu{��Ai � ��,��� � � ta� �.�� �� �'�i���c���� i � r iVa' � <br /> �r 7 � �it ua� �_� . � �1� �1 � �i T C� �. � , � <br /> i-!n kla.yyre`���tE r� �)J�`'F-.�1J l4t�� ��1��'�7� ��FY� J��t�t�. � 1 � 1„ <br /> a � <br /> '-i i.,�.lq7i�q . __.�___ ` � _ <br /> ❑ Yes,this sectian applies <br /> The replacement of a Residential fixture or annliance 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 T�500.00 or less;excl ' *lhe cost of the fixture or appliance: and <br /> 3. Is improved, installed or replaced 4�y the homeowner or licensed contractor. <br /> Skip nexc section, if this applies; C'ost of Permit $ 15.00 <br /> State Surchorge $ .50 <br /> Mail-In I�ce(If Applicable) $ 1.50 <br /> Total 1Permit Fec $ <br /> , .) �,t, .- .`' �'{�t..�� "�rfi1, . .`t i��f�i: �`�,. ,..a..�:..� .'�:. � JITIal�� � :a;.irfi i i��lE+r�3n,::�Sn£'�..?4�3.. <br /> iiUni�I�'i'•GC��S�,���tllll Y'�i lL�ku.•: ...�r. <br /> ,. .'. <br /> lf above does not apply;follow guidelines below: <br /> I. COIYTRACT FR1�E * is I.25%of conlract price with a(I�linirrnum Fee�of:635.00) <br /> i ��Ca 1'��" x .ai2s �_.�'�.��� _ <br /> (cnntracl price) (minimum$35.00) <br /> 2. STATE SURCR[ARGF, ** Add the State Bldg Code Div.Surcharge(�linimum Fce ofS.50) <br /> �•�- ����" . x.0005 $ � :�l...t <br /> �(onl.raic.pricc) (minimum$ .50) <br /> 3. POSTAG�& H�NDLING(Only on Mail-In Applications) $ 1.50___,_. _.___ <br /> 4. '1'OTAL PEI�M['I'FEr(Add L.ines 1-3 Above) S ,�'�� � � � <br /> ■ * CONTRACT PRIC� or JOB CC)5T means the actual or estiroatcd dollar amount charged for the <br /> permitted work includinb materials, labor, profit,and other fixed costs. it is the amount to be charged <br /> to the customer for the wc»•k donc. If�iy materixl, equipment, labor or installations are furnished by <br /> the owner, tenant or any other party,the rcasonable market value of such items must be added to the <br /> estimated cost or contract price far permit fee purposes. 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 contraet. <br /> ■ ** The STATF SURChIARGE is.0005 of the auildin�Department at(952)249-4600 for the price. <br /> ,� .. , r i ....,. ;j '1.� .:._�. . _ '� yp��� '� ' � f /-P f I'' 3 . :}: <br /> �.:s��xr�+m ExA.��� q i i�j�isu : ��:. � t: `�.f:�.7�.� . ,��i:i ... .- " �. -i' .�.,.:.,���i��„�Y. ..r �.�'...�^':.�. �.�aa.. �i�i���,ri3..�r?y.u <br /> The undcrsigned 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 certif'tcs that. all statements made on this application are complete, true and <br /> correct. ..� <br /> .� 1 r.� <br /> 's i atur�e: �: � � � Uate: `� O �} ���� <br /> F1ppl�cant . S gn "'__ _ <br /> — <br /> ) �----_____._.. <br /> i��S��.�o� <br /> ��.'` . . ._. ............�..14�.F.l.;n:.� � . . ...-.. <br /> 3 <br /> + .r <br /> i' <br />