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-, , � <br /> r� ` F <br /> � , . <br /> . <br /> � . � � � ��. <br /> �������, �� ti ��� <br /> , <br /> `�� , _ _ � ��. �1 � .�: G�"`: <br /> ❑ Yes,tHis section applies <br /> The replacement of a Residentia]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 Iess;excludin�the cost of the fixiure 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 $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> !Erw �"i 7a:;e. *s t � vK.-�'....,'� .•,.r���� .�x�.. <br /> ,��a�>fs��������'E ' ' .���������T;�,�� ,bN( �— �°B�z'a���. 0�u, Q �,�� �� � <br /> k r � ���.r�.� �-;5�. <br /> If above does not apply; follow guidelines below: <br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00) <br /> '�� x.0125$ �05�� <br /> � (contract price) - (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$.50) <br /> �o��� x.0005 $ c�.(Qp� <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} $ (p Gf.�� <br /> ■ * CONTRACT PRICE or JOB COST' means the actuaI or estirnated 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 Department at(952)249-4600 for the price. <br /> � � µ�'� � , f�t� i, � ;������ ��}, � -x�� � � . <br /> _. ti 1� ».� �y,�. 2,� A ., <br /> �a �y � <br /> t�����?n .,u�rl�-- '- �'r b. tr�'t �4'",�Nt��'�"�t�rv1r:S�'�r.,�r,5�� <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 sta.tements made on this application aze complete, true and <br /> correct. <br /> Applicant's Signature: L�. Date: �] —g—��� <br /> �-< � t ��-- , � , �7 '�— <br /> N�� n "X 4V C 'i 'c�"� . <br /> _ � d�� ;' ti�� 't� ... <br /> f�d1 ! a t q"55FaF�Jt�.rJ�.�i'����'�'�i��,�.�� (� � <br /> r�`���M-� w �i,�» s� , ��. F b"�.'',� <br /> �.. ... ...� , �in�.;�;ur f...�.�>_'�.� �r. ��.. �"_r., <br /> 3 <br />