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03-16—'15 11 :38 FR011— 1-606 P0003/0004 F-760
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<br /> 0 Yes,this section applies i
<br /> The replacement Of a Residential fixture or appliance that meets all three of the following requirements:
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<br /> 1. Dos not require modification to electrical or gas service.
<br /> 2. Ha a total cost of$500.00 or less;excluding the cost of the fixture or appliance:and
<br /> 3. Is i proved,installed or replaced by the homeowner or licensed contractor.
<br /> Skfp 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 $
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<br /> If above does ndt apply;follow guidelines below:
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<br /> 1. C�NTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
<br /> �5 L
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<br /> x.0125$ .!
<br /> (contract price) (minimum$50.00)
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<br /> 2. STATE SURCHARGE 3 .'5151 7
<br /> x.0005 $
<br /> (contract price)
<br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
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<br /> 4. TTAL PERMIT PEE(Add Lines 1-3 Above) $ J I °
<br /> CONT CT 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 cu omer for the work done. If any material,equipment, labor or installations are furnished by
<br /> the owne ,tenant or any other party,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 o the job cost,the City may request the submission of a signed copy of the actual contract.
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<br /> The undersi ned hereby applies to the City for issuance of a Mechanical Permit,agrees to do all
<br /> work in str' t 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. 1
<br /> Applicant's Signature: _ Date: 5/1 (C2//5
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