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M ^ <br /> + ���1�b��� �'�'� �f�����T�..�d����5} <br /> ' 2002 State Statute ❑ Yes This Section AppIies <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: <br /> and <br /> �) Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip next section; Cost of Permit $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee $ L50 <br /> If above does not apply, follow guidelines below: <br /> �. �antract P�-ice* is .012S% of job with a 1!'Einimum Tee of($3�.00) <br /> � �'• � x .0125 � ��.�� <br /> (contract price) (minin�um�35.00) <br /> 2. State �urcharQe. ** Add the State Buildinn Code Division a Minimum Fee of($ .50) <br /> ��lV�".� x .0005 $ � �� <br /> (contract price) (minimum� .50) <br /> 3. PostaQe at�d I�andlin� (�rzly f�iai!-i�z rtpf�l�catiorrs) � �_� <br /> 4. ��'�'�'4.L ��F����' ��� Add lines 1-3 above � - <br /> � � � _�3� S.�Ti <br /> "CONTRACT PRICG�or JOB COST means the actual or estimated dollar amounC charged for the permitt�ed��ork including <br /> n;aterials,labor,profit,and other fixed costs. It is the amount to be charged to the customer for the work done.If any material, <br /> equipment, labor,or installation is furnished by the owner,tenant or any other parry the reasonable market value of sucki items <br /> must be added to the estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the amount of <br /> the job cost,the City may request the submission of a si�ned copy of the actual contract. <br /> **The STATE SURCHARGE is.0005 of the contract price under$I,000,000 or�.50-whichever is greater. For valuations over <br /> ;I,000,000 call the Department of Inspectionaf Services for the price. <br /> The undersigned hereby applies to the City for issuance of a Mechanical Pennit,agrees to do all work in strict accordance with <br /> thc ordinances of the City and the regul ions of the Minnesota State Building Code,and certifies that all statements made on this <br /> applicatio� are complete,true and co t. <br /> Applicant's Signature: � Date: ) <br /> Approved By: Date: <br /> 3 <br />