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r <br /> ` . r <br /> 1 <br /> i�i01`'ldi d'LS:. I.f�LCVL=11d��11S� <br /> 20d2 State StatutP ❑ I'es "I'his Sec�ion��plies <br /> The reptacement of a Residentiat fixture or appliance that meets ail three of the foIlowin�requirements: <br /> 1) Does not require modification to electrical or gas ser��ice. <br /> 2) Has a total cost of$�00.00 or less; excludinQ the cost of the fixture or appliance: <br /> and <br /> 3) Is improved, installed or replaced by the homeowner or Iicensed contractor. <br /> Skip next section; Cost of Permit $ 1�.OU <br /> State Surcharge $ .50 <br /> Mail-In Fee $ 1.50 <br /> If above does not app!y, follow juideiines below: <br /> 1. Can�<act P�-�c�* is .012�% of jo'o with a b�iaimum Fec o€($3j.00) <br /> �` p0 <br /> LU / x .012J � <br /> (oor,tract price) (minimum$3�.00) <br /> Z. State SurcharQe. *� Add the State Buildin�Code Division a�Iinimum Fee of(� .50) <br /> .� .000� $ <br /> (contract Nrice) (min:mum� .50) <br /> 3. PQstaQe an� �Iandlina (O�tdy niail-irt applicatiorrs) $ l.jp <br /> 4. T��'AL ��A2.ti��'F' �E� (Add lines 1-3 above) � <br /> *CONTRaCT PRICE or JOB COST means the actual or estimated doilar amount charged for tne perrritted work including <br /> materials,labor,orofit,and other fixed costs. It is the amount to be cFarged to the customer for the work done. If any material, <br /> equipmen[, laoor,or installation is furnisned by the owner,tenant or any otner parry the reasonable market value of such items <br /> must be added to the estimated cost or contract price for perrnit fee purposes. [n the event tnat there is a dispute on the amount of <br /> the job cost,the City may request the submission oi a si�ned copy of the actual contract. <br /> **The STATE SURCHARG6 is.000� of the contract price under�1,000,000 or�.50-whichever is greater. For valuations over <br /> �I,000,000 calf the Depar[ment of Ir.spectional Services for the price. <br /> The undersi�ned hereby apolies ro the City for issuance of a:�f�chanical Pennit,a,ees to do ai work in strict accordance wiih <br /> the ordinances of the City and the regulations of the Minnesota State Building Code,and certifies that all statements made on this <br /> application ar�compiete,true and correct. <br /> Applicant's Sijnature: Date: <br /> Approved By: Date: <br /> � <br /> � <br />