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i � <br /> � �� � � � � ���� t � �� � � � <br /> ��'� � 3� ��f x �. ��.. - � € ' , '�a, �c,�„f .� `� �"r ,� � �� <br /> � �$����:�5�q'� �� �� �� �-�� 4� ��'"'�t ...�. � ��� . �. . �� z Y`� � 6� � ��, '��c: <br /> e.; <br /> , e,- ._..... �e,.,�., .- .,..;. ;_ . ... . . ..�. ,. .., � ..s - _y.,- «*�: <br /> � � <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;excludin¢the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. � <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 1.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ � <br /> � � �� � � � � h� a. <br /> � . <br /> � ; <br /> � � . � ' � <br /> � , <br /> , 5 <br /> � <br /> �"'� ^ „��� r <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> x.0125$ <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> x.0005 $ <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollaz 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 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 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 /> ,, <br /> .- <br /> <<�2�°'`'��5a ��� ��` �3� TM��`�� �` :v�a��x�. ��. <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 /> � <br /> �, <br /> Applicant's Signatur Date: S <br /> 3 <br />