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06-02—'15 12:12 FROM— T-865 P0003/0004 F-052 <br /> D Yes,this section applies <br /> The replacement of a Residential fixture or appllan%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; Ig p udin g 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 /> '� _ .S•n � '` �r' _ ".•uiQ Q r W'ef� iZt°N�vr'T <br /> If above docs not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> $3199.60 <br /> WE- <br /> 2, STATE SURCHARGE <br /> $31139.604 ,, ' <br /> x Y 1.60 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) <br /> 4. TOTAL PERMIT FEE Add Lines 1-3 Above) :. �_ .tuz <br /> ■ CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted 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 furnished by <br /> the owner,tenant or any other parry,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 /> i <br /> i <br /> 1 <br /> I <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all j <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 /> i <br /> Applicant's Signature: G'1^l/f�LG''L8'l�' ?at ..'; 6/2115 <br /> 1 <br /> 3 <br />