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'��`�`�^������e����`�� ��ik : �1:r� �rvp � � ' .� 3� � ����� a*��,� �� - �,. <br /> �'�;s`�:r,`'���"�`<':�"�: .����"��"�'���i�;�i����� ° � �.��@ i:1�x� �. �.�, � s: .. <br /> wi S. .� .1 e�.�.-- �� ".V',,, �.w.a�, <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 $ I 5.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> , �� <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00) <br /> �/�� �U•� x A 125$ l �U�� <br /> (contract price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surchazge(Minimum Fee of$.50) <br /> � �/ 'IJ� � x.0005 $ 6.� <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> � �D <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �S // <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollaz 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 /> ,�, <br /> k.: <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 /> , ,-'��. <br /> Applicant s Signature�.,-- /� �� Date: ''�!/ 'U <br /> , PI ' , . <br /> 3 <br />