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Fi �� �r..'!� .� : .;��� .. s � ` �' �� �,''� ���,�y,� �y�.�'}�$ ��,y' <br /> pg� T Y. � F; <br /> �R`�.'duw �S9���yb"� <br /> �, rvpa"��i.W.#k� '� ,1d �` ^�.�:��4�.gq�s� �T� A � � �'. <br /> .�..+y :�,�- �1"8'�.;�-�'�*-,��� . <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements: � <br /> l. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludin¢the cost of the fixture or appiiance: 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) $ I.50 <br /> Total Permit Fee 3 <br /> �� t�y,��'���c�a. �. , � �' E,� a' .'�- � �� �`_ r.' <br /> {�°��a'ts5'�y`��.x,"�,��''�... ; 'e�`"�'�. � 4�� �. � r�,�" a�w �+� `�Sa „b�: <br /> If above does not apply;follow guidelines below: <br /> l. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00) <br /> � 3�/7�� x .0125$ / 3 yY <br /> (contract price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50) <br /> � 3y78' X.000s $ � '� <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> � <br /> �s=- <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> , <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. [f 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 /> �',�a �`�"'��� , "� "r�� ��' �`� <br /> � �i *' ��� �ra •i. <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 /> ApplicanYs Signature: Date: <br /> �'f��� <br /> �,���''u d�,,g�.�E'�.�t,Je5c�``�{ p�"s�2�"� a �I�'�� - �'�j <br /> ��k�.� �.� ��+E'��" ze �� �E � �„9 <br /> � �Y <br /> ����. _ .,�,. ; � ��, <br /> n�, . 5fi a �� .�. �;� 3 <br />