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. + . � <br />� ,2,�s`,., l � l� p ::�+M�K�����������£�� �.�.. �/ ��. £����d y 1 <br /> � � N�. <br /> : � � ���a ' (�`� j� � t `� €c�4����b��j� . <br /> �'"�'"-,t �,I�.`?'�.'.�A� .�����=V��'�.�1"'��V��,�������, -.,���a.��. . � il„ , � .Y�, <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; excludine 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 /> ������,��i�i�.����1�.��� . � --,�� � .�=�Jr��.���,�, <br /> If above does not apply; follow guidelines below: <br /> 1. CONTRACT PRICE * is 125%of contract price with a(Minimum Fee of$50.00) <br /> `�I g55. UU X .oias $ �g. I `� <br /> (Tcontract price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> `1 gSS. (ro X.000s $ 3 ��l 3 <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ I G� . � 2- <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated 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 pariy, 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 /> ����3�D_i�i\ ;��!�.W+ ���.l�- 3.�$���� ,,.�,,.�����L��� � �, <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 I -I 3""I s <br /> 3 <br />