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M � <br /> l <br /> • E�S�e.19�fi21 d`L�` ��Al�V 1J.`i d L�:\(�7� <br /> �00� Sta�� �tata�te ❑ Yes This Seetion�.�pdies <br /> Tl�e replacement af a F�esidential fixture or a��pliance that meets all three of the following requirements: <br /> ]) Does not require modification to elech-ica] or gas service. <br /> 2) Has a total cost of$500.00 or less; excludin� the cost of the fixture or appliance: <br /> and <br /> 3) Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Slcip next section; Cost of Permit $ 15.00 <br /> Staie Surcharge $ .5� <br /> ��ail-In Fee $ 1.50 <br /> If abo��e does not apply, follow guideiines below: <br /> �� �;'�aaa�z-��t ��-a���� �s .0125% of job v;it11 a i�inimucn I�ee of��:�5.00� <br /> ���x .0125 $ � <br /> (contract price) (minimum�35.00) <br /> 2. �da�e wurei�ar��. ** A.dd the State Building Code Division a 11�izairaaur� �'ee of($ .50) <br /> x .0005 $ �SS <br /> (contract piice) (minimum� .50) <br /> 3. �'os�ave anti�andiir�g (�ril��nzcaif-ira ap�liccaEio�as) $ 1.50 <br /> 4. '�'CB'�'AL ���'I��' ��� (Add lines 1-3 above} � _ 35,�� <br /> *CONTRACT PRICE or JOB COST means the actual or estimated dollar an�ount charged for the permitted worl<including <br /> materials,]abor, profit,and other f xed costs. Tt is the ainount to be charged to t�e customer for the work done.If any material; <br /> equipment, labor,or installation is furnished by the owner,tenant or any other party the reasonable marl<et value of such items <br /> must be added to the estimated cost or contract price for permit fee purposes. In the event that Yhere is a dispute on the amount of <br /> thejob cost,the City may request the submission oi a signed copy of the actual contract. <br /> **The STATE SURCIIARGE rs.0005 of the con4�act price under$I,000,000 or 5.50-whichever is greater.For valuations over <br /> �I,000,000 call the Department of Inspectional Services for the price. <br /> The undersigned hereby applies to the City for issuance of a Mechanical Pen��it,agrees to do all wor};in strict accordance with <br /> the ordinances of the City and the regulations of the Ninnesota State Building Code,and certifies that all statements made on this <br /> application are complete,true and correct. <br /> � +� � /�� <br /> Applicant's Signature: Date: — '4—V� <br /> Approved By: �— Date: <br /> 3 <br />