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Sep. 20. 2013 10:36AM No. 7184 P. 4 <br /> B. E,�; ;P;LGUj(ATIQN( <br /> :BASED OFR--20,02-S`PATF3:STATUE <br /> Q <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;excluding 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 $_._,1.00 <br /> Mail-In Fee(If Applicable) $ Z0Q <br /> Total permit Pee $ U.00 <br /> %PBR}1I�ITFEI3.CAL [JIiATIC►N JOBS=0V1�R$10-0.6", <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE »is 1-25%of contract price with a(Minimum Fee of$50.00) <br /> (Ju <br /> x.0125$ <br /> (c nuect price) (minimum 950.00) <br /> 2. STATE SURCHARGE <br /> x.0005 $ <br /> (Conirad price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 190 <br /> a. TOTAL PERMIT FEE(Add Lines 1-3 Above) S <br /> ■ CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials,Iabor,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 /> WHAMaL PERI1 AISPLICATIDN'AGrRLE1VlENT <br /> Tho 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: Date: �117'2 3(7 <br /> 3 <br />