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r • <br /> � � ' �� � <br /> � 5 . � <br /> r �. w _����` �' <br /> � � - r� -: i�- � e d��' �wa <br /> 5✓ � �; <br /> � � <br /> ,�; �, � <br /> � �'E.;.,.,� f s . � ��. <br /> 5Y� � <br /> �` <br /> �,9� :.3�p �."J �.�, �'�, ? <br /> "�.. :=. , ,.. :. .° ... �. ,... 9 � '..� ,, , , .�, , ... �„>. �.� � _/,����#�a,�_.x.... , ... ,: <br /> �j 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;excludinQ 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 $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> ,�� "� � �����`��=��� ��;t� �(�< � �. �!�� � �� � ���'� <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$50.00) <br /> x.0125$ �% � � <br /> (contract price) (minimum$50.00) <br /> 2. STATESURCHARGE <br /> x.0005 $ <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <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, tabor 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 /> x � „ <br /> ' <� ���;:�'����'�'.'��'�.�t�A. � ������ � �„� <br /> � <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: � �� <br /> 3 <br />