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•!►� <br /> K � <br /> P'ERI���' F�� ��;LC�JLAT�O�(S) <br /> ZOQ2 Sta�� Stataxt� 0 ��s�'his Seetion�.ppiies <br /> The replacen�ient af a P`esidential fxture ar aupliance that meets all three of the following requireinents: <br /> 1) Does not require modification to eleetrical or gas service. <br /> 2) Has a total cost of$500.00 or less; excludin� the eost of the fixture or appliance: <br /> and <br /> 3) Is improved, installed or repIaced by the homeowner or Iicensed contractor. <br /> Skip next seetion; Cost of Permit � 15.00 <br /> State Surcharge $ .50 <br /> �ail-In Fee $ 1.50 <br /> If above does not apply, follow guideIines belo�v: <br /> 1• �'ontra�t �'��ia���' :s .0125% of job with a l�'�inifnum Fee ��(��S �301 <br /> 3�5�� �� x .0125 $ /,S�l'j <br /> (contract price) (minimwm�35.00) <br /> 2. �tate �urc�l�arffe. **A.dd the State Building Code Division a ld'�inPmum, �ee�f�� S�} <br /> 3�f�c? O�, x .0005 $ � �v <br /> (contract price) (minimum� .50) <br /> 3. �'€�s�a�e and I�andiin� (�rad��trzrcil-irr c���nlicc�ti��a�s� � � <br /> 4. T'�b'�'�I, �'��.���' �'�� (Add lines 1-3 abave) � �`� <br /> $ ��_� <br /> �`COtJTRAC"I'PRICE or,JOB COST means the actual or estirnated dollar amount charged for the permitted vdor]<including <br /> materials,labor,profit,and other fxed costs. Tt is the amount to bc charged to the customer for tlle work done.If'any mat��rial, <br /> equipment, l��bor,or instal(ation is furnished by the owner,tenant or any othcr party the reasonable market value of such items <br /> rnust be added to the estimat�ed cost or contract priee for permit fee purposes. In Che evenC that there is a dispute on tl�e amount of <br /> thejob cost,the City may request the submis,ion oi a signed copy of the actuai eontract <br /> **The STA'3�G SURCT-IARG�is.0005 of the contract price under$),000,000 or$.50-whiehever is greater. For valuations over <br /> o],OOO,OOU cal(the Department of Inspectional Services for the price. <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit,aryrces to do all work in strict acc <br /> the ordinances of che City and thc re ations of the Nii icsoYa State T3uildin�= � ordance with <br /> �Code,and certifies that all statements macle on chis <br /> application are complete,true and ect. <br /> A licant's Si � <br /> pp �nature: _ �� Z! �� <br /> Date; <br /> A��proved By: � <br /> Date: <br /> 3 ! <br />