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s <br /> . r r-� �5:�+�\�1 s���„✓ . : - <br /> � <br /> . . �� ;'�. 'c�,�..�', _,. ::iL7�����I'i'„�, ���F,. :����.�1���,�r:: 3�'����y ��� � »�..5�... ., �t <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance 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 Surchazge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> ����,. ���''��. �'�T�VIT����� . � ��'�'�� �. -»�t�!B�i�,,,, . �� � ��.:� �.. ;:__ . � <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$35.00) <br /> 19,500.00 x.0125$ 243.75 <br /> (cont�act price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$.50) <br /> 19,500.00 x.0005 $ 9.75 <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> 255.00 <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 fumished by <br /> the owner,tenant or any other party,the reasonable mazket 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 /> � .. ..', ����'���.:�����`�"�P�����`�'�{��:��' �;...._... _. � : <br /> ���- ' <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 State of <br /> Minnesota, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: ���'�'LU Date: l i/o7/o7 <br /> , „. � 4 �...... ...... . <br /> .. .. ���E'' : <br /> t���, �PtSk��.�i7��tlf1 �� i <br /> a �......�: _�......: _,.._.:����.�.�.�'w ...__� <br /> 3 <br />