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- . <br /> - ' P,.�I2ibJ�I'FE��i��i��TIOI�i���.: <br /> . BA.S�D��F�-Zfl4�;S`�'�.`£�STA'�'E� ` <br /> ❑ YEs,this seetian applies ' <br /> The replacem�nt of a Residential fixture or appliance�hat meets al�ttuee of�lie fallowing ret�uirements: <br /> 1.' Does notrequiremodificadon to electric�l or gas seavice. <br /> Z. Has s;totat cost of�SOU.flU or less;�xcle3cliae the�vf the€"rxtur�or sppiiance:enc� <br /> 3.: Is improved,installe�or replaced by the#�om�wner or Iicensed conhactor. <br /> Slrtip nezt�ection,i�this applies; �ost bf Pernut � 15:d0"` <br /> State Surcfiarge ` $ .5t� ` <br /> Mail In�ee(If�rlicable) � ; 1.50 ` <br /> fiotai Permit Fee:: S <br /> -PE�LMT�':FEE CA�.G�.AT�(33�T�S =Jf3�S.�OVER-$SOf�.UO ' <br /> If above does not apply,foflow guideliu�s belc�w; <br /> 1.- �ONTRACT PTrIGE *is 1.25%of contrdct�ice with a(Minimum�'ee of S35.00) <br /> 2t���C,� ` ` <br /> �.ai2s� �Q:� ; <br /> t��i��j �rtanirt�m S35.U6) <br /> 2.: STAT�SURCHkRGE '�'':Add the Stat�B3dg C�de 73iv.Stu�charge(Minimum F'ee of 5:50) <br /> Z���`��. x.E�E}5 $ ��,�.Z. <br /> fcontract price} {riunimum S .50) <br /> 3. Pf�STAGE 82 HANDLI�G(Oniy on Mail In Applicat�ans� $ I.50 <br /> 4. TOT�iL PERIYI�T�EEE(Acid i.ines.I-31�bove) � ��:� <br /> � * COIdTRAGT PRIGE or JflB Cfl�'F means the actual or estimated tioiiar amount charged fQr th� <br /> pemutted work incluzling inatertais..l�bor,profi�a�td otber,fi�ced costs. �t is the an�oimt fn i�e cl�arged <br /> ta the customer for the work clane. �f atry material, squip�n�, labor or insta�Iations are f'urnished by <br /> the owner,tex�ant ar at�y other party,ti�e reasonable marl�et ualue of such:ifems mt�st�se;addet�to the� <br /> estimated cost or contract pFice for pernut fee purposes. In the event that ihere:is a dispute on the <br /> amount of the job cos�, the �ity may re�uest the submission of a signed cogy of.the acttial contract. <br /> ° **The STATE SURCI�ARGE is.0045 ofth�$uildiug-Deparfinent at(952)249-�160()for the price: <br /> �vIECIHAIdIC1��,I:PE�4T''�lP��I�,.�f3�AG�EEME�' .. <br /> �'he u�dersi�red hereby applies to the�ity for issuance�f a�esha�ical Perniit,agees to do a�1 <br /> work in,strict a�cordance with the ardinances of the City �n� the reg�rlations of the, State of <br /> Minnesot-�;, and c�rtifies_t�at all,statements made on thi:s application`:are camp�ete; true anci <br /> correct. <br /> Applicant's Sig�ature: ��te: � `��e1�� <br /> 3 <br />