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. <br /> �'���,�: <br /> ar � <br /> b; � L �� r. <br /> "#. �,.A"�. <br /> ❑ Yes,this section applies <br /> The replaceme�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;excludins tt�e cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by�e homeowner or licensed contractor. <br /> Skip next sectioq if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> � v <br /> �.- <br /> If above dces�t apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(1Vlinmiam Fee of$35.00) <br /> 75,150.00 x.0125$ 939.38 <br /> (conhxct�e) (minimum 535.00) <br /> 2. STATE SURCHARGE ••Add the State Bldg Code Div.S�charge(M�imum Fee of 5.50) <br /> 75,150.00 x.�5 $ 37.58 <br /> (COIIh'Sd�[ICC� (minimUlil S .SO� <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> 978.46 <br /> 4. TOTAL PERNIIT FEE(Add Lines 1-3 Above) $ <br /> • * CONTRACT PRICE or JOB COST meffis the actuai or estimated dollar amount chazged for the <br /> permitted work including materials,labor,pmfit,a�d other fixed costs. It is the amount to be charged <br /> to t�e customer for the work done. If any material,equipment,labor or installations are fiunished by <br /> the owner,tenant or any other party,the reasonable mazket value of such items must be added to the <br /> estimated cost or contract price for permit fee purposes. In the eve�that there is a dispute on the <br /> amount of tbe job cost,the City may request the submission of a signed copy of the actual conttact. <br /> ■ s•The STATE SURCHARGE is.0005 of the Building Depatlment at(952)249-4600 for the price. <br /> �'� f<�� ._ <br /> �y�: <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 statements made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: Date: <br /> - � � ti Y" 't�{ ��.�}R^'. �f � <br /> 1�ix <br /> ��-"Y-`C Y�� �} ��'*"�^r�'��*�'�y`�. <br /> ;.c`+.`+t ^,:� 2+` ,y_„ 4 Fr �.� `?j..."3��.�'i,M1 .. <br /> 3 <br />