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08/18/2004 09:19 FAR 763 591 6071 IVERSON [�005 <br /> � ' . � <br /> ��IT FEE CALCULATInN(c� ��Z �,� ��-�o+�. ��� <br /> 2002 State Statute Q Yes, This Section Applies <br /> The replacement of a Residential �Yn��e�R li n that meets all three of the following • <br /> requirements: <br /> 1) Does not require modification to electrical or gas servi�e. <br /> 2) Has a total cost of$500.00 or less; �cludinQ the cost of the fixture or applia.nce: <br /> and <br /> 3) Is improved, installed or replaced by the homeowner or licenced contractor. <br /> Skip next section; Cost of Permit $ _ 15.00 <br /> State Surcharge � .50 <br /> Mail In Fee S _ 1.50 <br /> If above does not apply, follow guidelines below: <br /> 1. Contract Price* is .0125 % of job with a D��um Fee of(�3� 001 , <br /> _ ��� � � .x .0125 S <br /> (contract price) (minimum$35.00) <br /> 2. �te Surcharge. ** Add the State Building Code Division a �iinimum Fee of$ .50) <br /> 720 0 � x .0005 S <br /> (coatract price) (minimum$ .50) <br /> 3. Posta�e and Handline (Only mail-ici applications) S 1.50 <br /> 4. TOTAL PERNIIT FEE (Add lines 1-3 above) S <br /> * CONTRACT PRICE or JOB COST means the actuat or estimated dollar atnou�t charged for the permitted <br /> ' work including materiats,labor,pmfic,and other fixed costs. It is the amouat to be charged to the customer <br /> for the work doae. If any material, equip�nent, labor.or installation are furnis�ed by the owner, tenant or <br /> any other parry the reasanable market value of such items must be added to t�r estimated cost or contract <br /> price for permit fee purposes. In the event that there is a dispute on the amouni of the job cost,ihe Ciry may <br /> request the submission of a signed copy of the actual conuact. <br /> ** The STATE SURCHARGE is.000S of the contract price under$1,000�000 or 5.50 -wluchever is greater. <br /> For valuations over$1.000,000 ea[1 the Depaztment of InspecNon Services for rl�e price. . <br /> . The undersigned. hereby applies to the City for issuance of a Plumbing Permit, agrees to do all <br /> work in strict accordance with the ordinances of the City and the re�ulations of the State of <br /> Minnesota, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> . <br /> Applicant's Signatur Date: �'C8� <br />