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�� � <br /> ! . ���, ��.�:�������-�pER1V1�1�F�j�A�CI�L��'��FICSN�S) � -� M�{�.��.���=��'��� ;:��, <br /> ` � OFF rt 2042;_STAT�S`EA��;U����� ���$ �`'r � ��� �� <br /> -_ BASED� <br /> .�}� �;��b r ' � ;��. <br /> ❑ - . Yes,this section applies � <br /> _ The replacement of a Residential fixture or appliance that meets all three of the following requirements: . <br /> 1� ;`r> � - 1. Does not require modificarion to electrical or gas service. <br /> � ; 2. Has a total cost of$500.00 or less;excludin�tfie cost of the fixture or appliance: and <br /> `,� 3. , Is improved,installed or replaced by the homeowner or licensed contractor. <br /> �� �, � Skip next secrion,if this applies; Cost of Pernut _ $ 15.00 - <br /> � <br /> li State Surcharge $ .50 � <br /> '` Mail-In Fee(If Applicable) $ `' 1.50 , <br /> Total Permit Fee $ <br /> � _ <br /> `,�t5` : > � ,.:-PERlyIIT�EE-C�L,CT�I;A`�IO�(�)` '#JOB��O�ER�SOQ:00�,�'.��X.�'�:,� ��;� <br /> If above does not apply; follow guidelines below: <br /> L CONTRACT PRICE *is 1.25%of contract pnce with a(Minimum Fee of$35.00) <br /> • . : , , � ..__::.. <br /> c � _ <br /> _ �qc�U� � x.0125 $ <br /> (contract price) (minimum$35.00) x,. <br /> � 2. STATE SiJRCHARGE **Add the State Bldg Code Div. Surcharge (Minimum Fee of$.50) � <br /> i�j e � <br /> ` -I J�C� -� x.0005 $ <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> � 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> • � * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted 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 furnished 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 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 contract. <br /> ' **The STATE SURCHARGE is .0005 of the Building Departrnent at(952) 249-4600 for the price. <br /> '`y` _r.=�MECHANICA.��PERMIT APPLICATIO�I�A.GREEIviEI�` ��k��� �,�rt�, <br /> x �'ce,�n, z� �� r X a <br /> . � �� ��:a �`+nn—. <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 regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: � � ����� <br /> Date: <br /> 3 <br />