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� 4 <br /> \, <br /> . <br /> PERivIIT FEE CALCULATION(S) <br /> 2002 State Statute ❑ 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 modification to electrical or gas service. <br /> 2) Has a total cost of$500.00 or less; excludin�the cost of the fixture or appliance: <br /> and <br /> 3) Is improved, installed or replaced by the homeo�vner or licensed contractor. <br /> Skip next section; Cost of Pernut � 15.00 <br /> State Surchar�e $ .50 <br /> Mail-In Fee y $ 1.50 <br /> If above does not apply, follow guidelines below: <br /> 1. Contract Price* is .0125% of job with a Nlinimum Fee of($35.00) <br /> C� G <br /> � r — x .012J � ��7• `�� <br /> (contract price) (minimum 53�.00) <br /> 2. State SurcharQe. ** Add the State Building Code Division a vlinimum Fee of(� .501 <br /> � 5 � � x .000� � �Z�.�'�/ <br /> (contract price) (minimum S.50) <br /> 3. Postaae and HandlinQ (Only mail-in applications) � 1.50 <br /> 4. TOTAL PERVIIT FEE (Add lines 1-3 above) � ��(D� -r�- � <br /> 'CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including <br /> materials,labor,profit,and other fixed costs. It is the amount to be charged to the customer for the work done. If any material, <br /> equipment,labor,or installation is furnished by the owner,tenant or any other party the reasonable market value of such items <br /> must be added to the estimated cost or contract price for peanit fee purposes.In the event that there is a dispute on the amour.t of <br /> the jcb cost,the Ciry may request the submission of a signed copy of the actual contract. <br /> **The STATE SURCHARGE is.0005 of the conttact price under 51,000,000 or$.50-whichever is greater. For valuations over <br /> �1,000,000 call the Department of Inspectional Services for the price. <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit,a�rees to do all work in strict accordance with <br /> the ordinances of the City and the regulations e Nlinnesota State Building Code,and certifies that all statements made on this <br /> application are compieteh'tru��d correct. � <br /> '� <br /> I � <br /> ` � <br /> Applicant's Signatur • Date: Cj- � ' �Y') <br /> Approved By: J <br /> Date: <br /> 3 <br />