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❑ Yes,this section applies <br /> The replacement of a Residential fixh�re or aDoliance that mcets all tluee of the following requirements: <br /> 1. Does not require modification to electrical or�s service. <br /> 2. Has a total cost of$500.00 or lcss;ex 1 ' the cost of the fixhue or appiiance:and <br /> 3. Is improved,installed or rcplaced by the homeowner or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee S <br /> If above does not appty;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of conhact price with a•(Minimnm Fee of 550.00) <br /> pd <br /> �' X.oi2s$ ��7�S� <br /> �•ontracc price) (mimmam sso.o� <br /> 2. STATE SURCHARGE r.� � <br /> -W x.0005 $ ` � <br /> (����) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PEItMIT FEE(Add Lines 1-3 Above) $ ��� `� <br /> ■ * CONTRAC'T PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including matcrials,labot,profit,and other fixod costs. It is the amount to be charged <br /> w 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. Ia the event that there is a dispute on the <br /> amount of the job cost,the City may request the submissian of a signed c�opy of the actual contract. <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: Date: �� I <br /> 3 <br />