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y <br /> �'ERMI�' �'E� �ALCULATION(Sl <br /> 2002 �tate �tatute ❑ �'es This Sec�ion�,�pt�es <br /> The replacement of a Residential fxture or appliance that meets aIl three of the following requirements: <br /> ]) Does not require modification to elech-ical or gas service. <br /> 2) Has a total cost of��00.00 or less; excludin�the cost of the fixture or appliance: <br /> and <br /> 3) Is improved, installed or replaced by the homeowner or Iicensed contractor. <br /> Skip next section; Cost of Permit $ 1�.00 <br /> State Surcharge $ .50 <br /> Ntail-In Fee $ 1.50 <br /> If above does not apply, follow guidelines below: <br /> �. �'�ar�fiF��ct�'�•��e* is .0125% of job v�ith a;i�ir.��a�rn Fee o�'(n'�5 00) <br /> c��c�0. E�., x .0125 $ ��. ��, <br /> (cortract price) (minimum 535.00} ^ <br /> 2. �ta�e S�rcE��r�e. ** Add tl�e State Building Code Division a 1�irnimum �'ee of(� ,SQ) <br /> �jZ%C�...� x .000� $ �. j� <br /> (contract price) (minimum$ .50) <br /> 3. �'c�s�a�=e a�d �at�ctlir� (�fcPy mai!-arr t�p4nZicrzti�ras) � — � <br /> `�• �'��'�� ������' �'�� (Add lines 1-3 above) <br /> � �vJ.� <br /> * CONTRACT PRICE or JOB CG�ST means t11e actual or estimated dollar amount charged for the pern�itted woii<inclu�ing <br /> maYerials,labor,profit,and other fir.ed costs. It is the amount to bc char�ed Yo the customer for the work done.If�ny material, <br /> equipment, labor,or installativn is furnished by the owner,te�iant or any other party the reasonable market va]ue of such iYems <br /> must be added to the estimated cost or contract price for permit r"ee purposes. In the event that there is a dispute on the amount of <br /> thejob cost,the City may rcquest the submission oi a siened copy of the actual contract. <br /> **The STATE SIJRCI-IARGE is.0005 of the contract price under$1,000,000 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 Pennit,agrees to do a11 work in strict accordance with <br /> the ordinances of the City and the regulations of the Minnesota Scate Building Code,and certifies that all statements made on this <br /> application are complete,true and correct. <br /> Applicant's Sib ture: �u.�c� ` �„_ Date:_ ��• s -v(, <br /> Approved By: � Date: <br /> _ 3 I <br />