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� , <br /> �, e r <br /> ���k��� " � <br /> g � <br /> , , <br /> ,��� � <br /> ..,�.� � �,r� s..r��E.� .,.�.. �:=.F� r:F,:; <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 $ .50 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> a,. ,'��; a w t .�. <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> �� ' x.0125$ ��idO <br /> (conuact price) (minimum$50.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surchazge(Minimum Fee of 5.50) <br /> x.0005 $ `��S� <br /> (contract price) (minimum$ .50) <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 chazged 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 aze 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 /> .<. , : .��;a , . , <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: T" ��O <br /> � ���+u� �+^V k�°''�,'��5��,�1•�a^�i����� ; <br /> .�(A ;,,,t,E .,,',!;t.+, . a �.. ��„'��_. . . <br /> 3 <br />