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• <br /> r <br /> 5���1 ��,�.C����A�uS.��" <br /> , ... . <br /> �E'li��r���i' ���S 1����� . _ - <br /> ❑ Yes,this section applies <br /> 'The replacement of a Residential fixture or appliance that meets all tbree of the following requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a to cost of$500.00 or less;excludins 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 Surchazge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Totat Permft Fee $ 22.00 <br /> � PE�RMIT FEE CA.I.CULATI -�BS�'�`ER��Qtf:�00 ` <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> '�a� Jc—�-�• t�x.0125$ �(Yp�,.sd <br /> (contract price) (miaim.m 550.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of 55.00) <br /> �' Sfrtsa .e.�U x.0005 $�e ,��� <br /> (contract price) (mi0imem S 5.00) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $�� GP�•-�� <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor,profit,and oti�er fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material, equipment, labor or installarions are fumished 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 petmit 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 times the Contract Price or a minimum of$5.00. <br /> ������l�..�" ° ` '�'�`���'��1��` ����' ` ;. '� :.., <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: � /Sr // <br /> :�'�t� 3 <br />