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� ' <br /> t , <br /> �EIZ.��IT F�� �A�.,C'�J�.�T'���v'(Sl <br /> 2002 State Statute ❑ `�'�s T'h�s �ec�ion A�SpIies <br /> Th;, replacen-ient of a Residential fxture�r a�pliance that meets all three of the following requirements: <br /> 1) Does not require modification to eleetrical or gas service. <br /> 2) Has a total cost of��00.00 or less; excludin� the cost of the fixture or appiiai�ce_ <br /> and <br /> 3) Is improved, installed or replaced by the homeowner or Iicensed contractor. <br /> Slcip next section; Cost of Permit $ 15.00 <br /> State Surcharge � .50 <br /> Nail-In Fee $ 1.�0 <br /> If above does not a�7ply, follow buidelines bela���: <br /> 1. �rAaa�a��e�t �P-ac�* is .0125% of jo'o with a,'��in�ay�aacrt �'ec af(��5 00) <br /> ____�'13%�.c�'� x .U125 � ��� .��_ <br /> (contract price) (minimum�35.00) <br /> 2. State Suret�ar6e. *�A.dd the State Buildinb Code Divisio�l a li'�inimnrra �ee mg'(� S�} <br /> __�%��'�' �,� x .U005 � �. �;; <br /> (conhact price) (minimum� .50) <br /> 3. �'€�s�a�e a�d �-I�nd���atB (�rily naail-�ri applicatio�r�s� $ <br /> �� <br /> 4• �'��'�� ����'�I�' �'�� (�`-�dd lines 1-3 above) <br /> � �7 9._3� <br /> *COt��TRl,CT PRRiCE or.JOB COST means the actual or estimah;;d doiar an�ount char�ed for the permitted woric includin� <br /> ma,erials,]abor,profit,and oC)ier fxed costs.ft is the an�ioui�t to be char�ed to ti�e customer for the work done.Irany maCerial, <br /> equiprnenf, Iabor,or installation is furnished by the owner,tcnant or any other p;irty the reasonable marl<et value of sucti items <br /> rz�ust be added to the estimated cost or contract price for pennit fce purposes. In the evenC Yhat Yhere is a dispute on tl�e arnount of <br /> the job cost,the City may requesC the submission oi a signed copy of the actual contract. <br /> *'�`Th�STATG SURC;-inRGG is.0005 of thc cvntract price under$1,000,000 or�.50-whichever is greater. For va)uations over <br /> n],000,000 call the Department of Inspectional Scrvices for the price. <br /> The undersigned 1lereby applies to thc City for issuance of a Mechanical Pern�it,aryrees to do all v,�ork in strict accordance with <br /> the ordinances of the City and thc regulations of the 1Vtinncsota State T3uildin�Code,and certifies ehat all stafements made on this <br /> appiication are camplete, true and correct. <br /> �LppJ.icant's Si�,,nature: J ,/Z�",���_ `� , � -�, <br /> Date: ,�-G o�— <br /> Approved By: ' <br /> Date: <br /> 3 <br />