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� <br /> . � <br /> PE�IVIIT�'BE CALCUI.ATION(S) <br /> BAS OFF-2002 STATE STATUB <br /> �� Yea,this section applies <br /> Tli�replsctmeat of a Rcsidmtial Sx or aDDli o that meets a11 thtee of the followi�g seQuirements: <br /> 1. Does aot ceqnire modi�cation to electiicat or gss serNicc� <br /> 2, Has a�,s�of$500.00 or less; 1 i the cost of the fixture or applia�ce:and <br /> 3. Is iiaproved,insralled ot regllacced by tt►e hameowncr or liceased coadracmr. <br /> Skip aext section,If this applies; Cost of Permit ��+� <br /> Stat�Surcb,arge $__.^ <br /> Mai7-�a Fe�(If Applicable) $�� <br /> Total Permit�ee S <br /> p�RMIT FE� CUL�.TION S -JOBS OVER$500.00 <br /> I�abuve does x�ot apply;follow guiddlit�es below: <br /> 1. CONTRACT 1'�2XC� °`is 1.25%of coatract price with a(Minimum Fee o�SS0.00) <br /> � ' ��$7S� x.o�2s$ ��0. oa <br /> (coatrac��rice) minimu 0. <br /> 2. STA1'E SU1tCHARG� **Add the 3tate Bldg Code Div.Surcharge(Miiaimum Fee of S.SO) <br /> soo <br /> : � 1� x.0005 S � <br /> � ���p�u) (triinimum S .SO) <br /> �� � �S�,CbfO� <br /> 3. POSTAGB&xaNnLn�G(oniy oa Mail-In Applications) � <br /> ,,.� ►-a J����rr• <br /> 4. TOTAL P��T FEE�(Add�ines t-3 Above) $ ��Gi <br /> �� « CONTRACT P�CE or JOB ICOST means the aelual or esrimated doll�c amoumt cbarged for t�e <br /> permitted work including�aat�i�ls,labor,Profit�and othcr 5aced costs. It is the amowrt to be chargal <br /> to the customer foz the work d.one. If say xttaterial,equipment,labor or installations ste furnishod by <br /> the owner,te�,aat or say other pbrry,tlae reasonable market value of such items must bc added to the <br /> estimated cost or eontract priee 1for permic fee purposes. Za th� eveirt tbat rhe�re is a dispute on the <br /> aznount of the job cos�the dty may rWuest tho submissian of a signed copy of the actual ceatracti <br /> �� "*'1'lae STATE SURCHAROB I8•0005 of the Building Department at(952)Z�49-4600 fox the price. <br /> . [ MfiCHANI PERMIT APPLICATION.AC}RE�MENT <br /> '1'he undersigned hereby applies t rh�City fox issuance of a Mechaaieal PetAait, agrees to do all <br /> r�rork in striet aecordamce witli �brdiaances of the City and the regulations of the 3tate of <br /> Minnesota, and cettif es that all statements made o 's application are complete, true and <br /> � cortec� <br /> A,pplicant's Signat� • Aate: L d <br /> Reset Fornt � <br /> N <br /> 3 <br /> � �d oz� �oN �ww wdbi �z� o�oZ ��z 'd3S <br />