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i <br /> ,,1.• 4•21A., t v k4t-,k�� ^ . ,�'"4.41 611. FBE`C�AI:,CLTL�ATION(S) ,:,� tr. , zF • <br /> • r ,# ,x i,Syu�� .1,,n �,.��(',J�j •i ar - s.t a 1 VY: �ryht*I-kt� ,i..,s�•x4:a:e K 'As°SAr 4) . spa i�ia•W IVC .� �, <br /> .x�t.��,.�.xr;,.�leu. . I,��<• �Y r�<A��ASED OFF;- 002 STATE <br /> _ .. <br /> ❑ 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;excluding the cost of the fixture or appliance: and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip next section, if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> PERMIT;FEE CALCUL'ATION(S)L;JOBS OVER$500.00 <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00) <br /> ( 00 x .0125 S 00 <br /> (contract price) (minimum 535.00) <br /> 2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of S.50) <br /> 0-0 <br /> W — x .0005 S , 50 <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE&HANDLING (Only on Mail-In Applications) 5 1.50 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S 37,, 00 <br /> • * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor, profit, and other fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material, equipment, labor or installations are furnished by <br /> the owner, tenant or any other party, the reasonable market value of such items must be added to the <br /> estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the <br /> amount of the job cost, the City may request the submission of a signed copy of the actual contract. <br /> • **The STATE SURCHARGE is .0005 of the Building Department at(952)249-4600 for the price. <br /> •MECHANICAL PERMIT APPLICATION AGREEMENT <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and c- ifie that all statements made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: _A , I Date: 7// Z/0(61 <br /> Reset Form <br /> 3 <br />