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/ <br /> � <br /> � �� <br /> ❑ Yes,this secrion applies <br /> The replacement of a Residential fixture or appliance that meets all three of the fol owing requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludinQ the cost of the fixture o appliance: and <br /> 3. Is improved,installed or replaced by the homeowner or licensed con actor. <br /> Skip next section,if this applies; Cost of Pernut $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> If above does not apply;follow guidelines below: ' <br /> 1. CONTRACT PRICE *is 1.25°/ of c ntract price with a(Minimu 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 doll amount charged for the <br /> pernutted work including materials, labor,profit, and other fixed costs. It i the amount to be charged <br /> to the customer for the work done. If any material, equipment, labor or ins llarions are furnished by <br /> the owner, tenant or any other party, the reasonable market value of such i ems must be added to the <br /> estimated cost or contract price for permit fee puxposes. In the event tha there is a dispute on the <br /> amount of the job cost, the City may request the submission of a signed c py of the actual contract. <br /> The undersigned hereby applies to the City for issuance of a Mechanica Pernut, agrees to do all <br /> work in strict accordance with the ordinances of the City and the re lations of the State of <br /> Minnesota, and certifies that all state s made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: Date: �� � ( 1 <br /> 3 <br />