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. , . e . - <br /> ❑ Yes,this secbion applies <br /> The replacement of a Residential fixUu�e or aimliance that mcets all three of the following requirements: <br /> 1. Uoes not require modification to electricai or gas service. <br /> 2. Has a total cost of$500.00 or tess;�xcludin¢the cost of the fixture or appliance:and <br /> 3. Is improved,installed or rtplaced by the homeowner or licensed contractor. <br /> Skip next section,if this applies; Cost of P�rmit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee S <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contcact price with a•(Minimnm Fee of 550.00) <br /> �al� � (� x.0125$ ���� <br /> (contract price) (minimam S.5o.60) <br /> 2. STATE SURCAARGE +( �,� <br /> C.�, (� x.0005 $� �Y <br /> (����) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S �� � � � <br /> • * CONTRACT PRICE or JOB COST means the actuai or estimated dollar amount charged for the <br /> pem:itted wark incl•sding m,aterials,labar,profit,sad other fix�costs. It is the amoun�to be charged <br /> W the customer for the work done. If azry materiat,equipment,labor or installations are furaished by <br /> the owner,teaant 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 of the job cost,the City may request the submission of a signed copy of the actual contract. <br /> The undersigned hereby applies to the City for issuance iof 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 a11 statements made on �hhis application are complete, true and <br /> correct. <br /> Applicant's Signature: Date: � � � <br /> 3 <br />