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J <br /> • <br /> - �, ��� r����'���.�z��u������r��� <br /> u � � <br /> • �� � � <br /> � . <br /> � :. <br /> ; �� �.. � _ �� <br /> � ls�� �� ���������c�z s�����.��� <br /> � ,� � <br /> ��� � � � <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or analiance 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;excludine 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) $ 1.50 <br /> Total Permit Fee $ <br /> �: ��. ' �+` _.. `. :��:�AL�`�.I`�:�:"�C}1'�� .-,�t�$�'+�YER.�S{��.Ot3� <br /> � �„ <br /> : �.,�.. ����: �� <br /> If above does not appiy;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25°/a of contract price with a(Minimum Fee of$35.00) <br /> 52,000.00 x.0125$ 650.00 <br /> (contract price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$.50) <br /> 52,000.00 x.0005 $ 26.00 <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> 676.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollaz amount charged for the <br /> permitted work including materials,labor,profit,and other fixed costs. It is the amount to be chazged <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 /> esnmated cost or contract price for permft 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 /> �, ' q : . l�ii���°�'�R'MfT`�'FLIC.ATI+t�N�CREEMEI'+Ifi .<,: <br /> L3 <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 Sta.te of <br /> Minnesota, and certifiss that all statements made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: Date: <br /> _. � ,�� � <br /> � <br /> � ; '� �+�se��+�rrf� � ,� , <br /> ��������_H_�a��' _ .___�. _� � ��_._._ <br /> 3 <br />