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. <br /> . <br /> .. �s � �.F���11��J��F�*���:�: ':��.... <br /> .:. '� � ����,�"�i������}� � : ..:. <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fi�ctwe or a�pliance 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;excludina the cost of ttie fixture or appliance:and <br /> 3. Is improved,installed or replaced by the hom�wner or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Totat Permit Fee $ 22.00 <br /> � PER1�vIIT�E-C�I.+�UL�'T'�U S -��t(}��$�0�� <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> ��a all1TO.t� x.0125$�� ��.uL� <br /> (contract price) (mioimem 550.09) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fce of$5.00) <br /> ��f ril�• �� x.0005 $� .S� <br /> (contract price) (mieimam S 5.00) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $� S 7 U� <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. If any material,equipment, labor or installations 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 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 times the Contract Price or a minimum of$5.00. <br /> �������.'����'.��:��%;i�� , � . <br /> T'he 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: / <br /> �� 3 <br /> ifi <br />