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Aua-05-20D2 10;43am From-CITY OF pRONO �9522494616 T-746 �.003/005 Fp270
<br /> FERMIT FEE CALCULA'1'YOl'�(S�
<br /> 2a�2 State Statirte ❑ Ye�'rhis Section E1,�rEili�s
<br /> 'I`he replacement of a Residential fixture or ap�liance that rraeets all thre�of the fallowing requirPm�nts°
<br /> 1) Does nat require modiflcation to electrieal or g�s sE:rvice.
<br /> 2) 1-�as a Cotal cost of$500.00 or less; excluding the cost af the fixttire o�appliance°
<br /> and
<br /> 3) Ts iiY�proved, ino�talled or replaGed by the homeo�vric;r br licenseci contractor.
<br /> Skip next seGtion; Cost of Permit $,,,,,,,_ 1�.00
<br /> State Sttrcharge $��50�� ,��
<br /> �!{ail�In ree $ 1_50
<br /> If aboye does not apply, folbw guidelines b�lo�v:
<br /> X. Contruct Frice* is .OlzS°/n caFpjub witll a Mitiimum Fee of " G.�
<br /> _��,� l�
<br /> .���.o�._x.012.5 `.6 �-�/�
<br /> (contract price) ._—!���.�.111.,,R.,....,__m,.e.a.,z�...�
<br /> (minimum$35,00)
<br /> 2. State Sulrcltar�e. **Add the St�►te Buildin��='ode l�ivision a IVlirairnuYn Fee af.��p,�.
<br /> <���i.�l�.� .�. .0405 � � ��.�v �,..�..
<br /> (contract price)A (minimum�,SQ)T
<br /> 3.Posta�e and Handlin;(Onfj�rnafl-in app(icrtioi�.$) $ �.1_Sp mm��
<br /> � �u
<br /> 4.TOTAT,PERMIT�E(Add lines 1-3 above) �;
<br /> �"CONTT2-4CT t�[t[CE or 14A CQST means ehe accual oe�stimu�ed dotl:u�amount cliar�ed for the permitted work inchadin�
<br /> materials, labqt,protit,and other fixecl costs.It is the amoune to be charged to the cuscomec for the work done.IP any matcrial,
<br /> equipmzn[,Inbor,or installation is furnished by ttie owner,[zotutt or any qther parYy the reasona6le marl�ec value of su.ch items
<br /> must be added to the esti�naied caST or AonCr�cl pricc foe pectnit fte puYposes,In the event that[here is a dispute on th�amdunt of
<br /> the job cost,[he Ciry ma,y reqaes[the aubmission o£a signed copy of fhe acnial con�ract,
<br /> *'�Thc STATE S[JE2CFiARG�is U005 of ihe contract pric�;under$1,00p,OD0 0�$,SO-whichever is greutcr.For val���[ions niror
<br /> $1,000,000 call tde�Deparm�enc of Inspeetjohal Serviees fbrr the price.
<br /> Thc andersigned hcreUy applies to[he City Por is5u�ncr of a r-lechanical Fermit,ai3rccs to do zU wt�rk in strict ar_r_ordance with
<br /> thr ordinances of the City and q�r regula[ion5 of the Minnesota State Building Codc,and cer[ifies Chat�11 statemen[s rnadt on this
<br /> application are complete,tYue at�tc!correei.
<br /> �
<br /> I1, (l /'�
<br /> Appliaant's Signat�ire: .�._. �- �.S[s�-..�,.n...na� r)ate:.�.,...,�.�7�.�..�J
<br /> Approved BY� .�._,�... �,.,..__�...�.�...�,_.....p,,..,n� Date:,� �....._
<br /> '�
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