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r �� <br /> . , <br /> �'����' ��� �A�CULAT�O�'(Sl <br /> 2002 �tate St�taz�:e ❑ �'es Thfis Sec�ion�.�pdies <br /> The replacen�ient of a Residential fixture or a�pliance that ineets al] three of the following requirements: <br /> 1) Does not require modification to electrical or gas service. <br /> 2) Has a total cost of$�00.00 or less; exeludin�the cost of the fixture or appliance: <br /> and <br /> 3) Is improved, installed or replaced by the homeowner or licensed cantractor. <br /> Slcip next section; Cost of Pennit $ 15.00 <br /> State Surcharge $ .50 <br /> N1ail-In Fee $ 1.50 <br /> If above does not apply, follow guideIines below: <br /> �. ��aa�a•��t �'�•i�e�° :s .0125% of jab ��ith a l���r��a���ax�� �i ee �g'(��5 �l6) <br /> 7.�c c.'u�— x .0125 � _`j�� ��U <br /> (contract price) (minimum�35.00) <br /> 2. Sta�e S�ar����r4ee ** Add the State Building Code Division a lt'�i�air�tam ��e cag($ 5�3} <br /> �u=:=�.�_x .0005 $ � i� <br /> (contract price) (miriimum$ .50) <br /> 3. �Qs�a�e and �aalc��ita� (�red,}�taaraiC-in c�p�licatiorr.s} $ �" <br /> 4. T'��'�k, �''�;�I�' k�� (Add 1it�es 1-3 abave} $ j[fi �� <br /> *CONTRACT PRICE or.10B C�ST means the actual or estimated dollar amount charged for the permitied worl<inc]uding <br /> materials,labor,profit,and ether fixed costs. It is the air�oui�t to bc charged to tlie customer for die work done.Ff any m��teria(, <br /> ec�uipmcnt, labor,or installation is furnished by the owner,lenant or any other party the reasonable market value of such items <br /> rnust be�adc�ed to fhe estimated cost or coi�tract price for pennit fce��urposes. ln the event ehat there is a dispute on the a��lo�ult�f <br /> the job cost,the City may request tne submission oi a signed copy of the artual contract. <br /> *'�`'The STA'i�SURCHARGE is.0005 of the contract pricc under$i,00U,000 or$.50-whichever is greater. Por valuations over <br /> $1,000,000 calf the Department of Inspectional Scrvices for the price, <br /> The undersigned hereby applies to the City for issuance of a Mechanical Pennit,a;rees to do all work in sh�ict accordance with <br /> the ordinances of the City and the regulations of the Ninncsota State Buildin�i Cede,and certifies that all statements made on this <br /> application are coniplete,true and c ect. <br /> Appiicant's Signature: _ � �- � � � _ � <br /> ��' Date:_� �s <br /> Approved By: � ' Date: <br /> 3 ' <br />