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c <br /> �• . . y ; ��. � ��: . � <br /> + ' � �' �r*.a�!�x� �',�#. �y� ����."��a{'�;�-� Y�3 � ''a- a£ � v„ -�' Yi 4 . <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 modificarion 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 tlus applies; Cost'of Pemut $ 15.00 <br /> State Surcharge $ .50 <br /> Mait-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ ; <br /> .. �. .- '� i ° ;����K �� ,?t� .,� � �:•; ° � .r� ,.Y`i,.�£J; '� i-i �4r...,�_ . . <br /> If.above does not apply;�'ollow guidelines below: , - <br /> 1. 'CONTRAGT PRICE *'is 1:25%of contract'price with,a�1VIinimum Fee of$35.00) <br /> � _ <br /> �tp'� d�r� x.0125$ �t.`��. O!� <br /> (con ctprice) (minimuatt$3S:OQ) ' � ° <br /> " 2. STATE,.SURCHARGE **Add the State Bldg Code:Div. 5urcharge`(Minimum Fee:of$:50) <br /> y`�,o,r�a X:000s $ �y, ov <br /> ,, (contract price) (minimum$-.50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $' 1.50 <br /> 4. TOTAL'PERMIT FEE(Add Lines 1-3 Abovej $�a'`Tf, e�+� <br /> : ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for,the <br /> pernutted workincluding 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 aze furnished by <br /> , the owner, 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 evenf 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 /> , " :.. . <br /> � , . r , s, �� � �k ,� �,�, <br /> ,.r. <br /> z � �3 ��. <br /> _ • ... ��,. ,,,..���. .,;. <br /> . <br /> _,s � �+:� . , d .M.. ..., _, ,,.,, r._.. .. .,._ <br /> The undersigned hereby applies to the City for issuance of a Mechanical Perniit,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 cornplete, true and <br /> conect. <br /> Applicant's Signature: - Date: � <br /> � <br /> 3 <br />