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�� <br /> � <br /> a �� � �� � ��������������� � � <br /> � � ,�f � ��� <br /> f � �� � � ����� ''-_� �`�`�.��:z��� � s <br /> ❑ Yes,this section applies <br /> The replacement of a Residenrial fixture or avnliance that meets all three of the following requirements: <br /> __� <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a tota.l cost of$500.00 or 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 next 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 /> � �., 'P��+��`����(:�,� '`` �,`I`.�(� � .=�� � <br /> `F � ����.�� :, �. <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> oG <br /> 0o d� X.o�zs$ <br /> (contract price) (minimum$50.00) <br /> 2. STATE 5URCIiARGE '�*Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50) <br /> x.0005 $ <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> pemritted 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 fiunished 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 STATE SURCHARGE is.0005 of the Building Department at(952)249-4600 for the price. <br /> .�I����U�y�+A.J�IL��„ ,�`r�����./���F�.����� <br /> The undersigned hereby applies to the City for issuance of a Mechanical Pernut, 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 cornplete, true and <br /> correct. <br /> Applicant's Signature: � Date:� — Z � — O`� <br /> 3 <br />