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� ' . <br /> s"�'�i�fl��.� �,a�. s '�:-'� ea#h�'$ r.� ��.��V��� .� ,����i��`�.0 t3 �:� � . �'���' '�"�'1 <br /> �, t �� r �,,�"�3�,��' �rt �a�t��'.'�. �`" �� �� , �-� �.� <br /> "� 3 ���` � ��..� � �s t��; ��`�.� ,�l ���„, ���• � � . �:.:' � �w�.w., �; <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture 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;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 $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> :���� � ' � � � ����, � � " � � , <br /> _ .���< .��,. ��" �. �: � ;��°'s <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> ���1�� x.0125$ ,�� � <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE '�*Add the State Bldg Code Div. Surcharge(Minimum Fee of$5.00) <br /> x.0005 $ �' � <br /> (contract price) (minimum$5.00) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �5 ' � <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estima.ted dollar amount charged for the <br /> pennitted 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 coniract 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 times the Contract Price or a minimum of$5.00. <br /> f" �,�. k �F '` � ^'�, � p, <br /> — �.v_ 5 <br /> �' `' t��:�"`��"�.' '� ��`.,r,y ��.5 � �,.5.�%`s 1 }I.�..e <br /> The undersigned hereby applies to the City for issua.nce 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 certifies that all statements made on this application are complete, irue and <br /> correct. <br /> Applicant's Signature: Date: Z Z )� <br /> 3 <br />