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� � � J � � 4 �'�� <br /> �+ ,�`�<a r.y��4 � `�'� '�' �`"� �' � *' r.'" ��.� t; �� ° � �� «,� ��s�,* <br /> =,�3?rF'` +� ..t. �� a�,�� .�ir'�� �,n.,..,0?.,5"1�;.,t�� <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 ar less;excludin�the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip neact 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 /> , .. ,. ., <br /> �, �v:,k,, y .r, �i�?I',� . F � - '�t ' k`�`��, t �,� dl���' <br /> .r� �... . � , „� <br /> .i..,., �.: v .,a° - ,'�`�,� : ,yx�"x�i2� 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$50.00) <br /> �f-� `l� xA125$ S�Co•3 � <br /> (coniract price) (minimum$50.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50) <br /> �G qo� X.000s $ 2 3•¢� <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ , . 0 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ('�O q•�rv <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estnnated 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, 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 STAT'E SURCHARGE is.0005 of the Building Departrnent at(952)249-4600 for the price. <br /> � , <br /> _ r,�, <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: `�Q ` �•�b <br /> r �`;��_,��, } <br /> 3 <br />