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• L <br /> PER1��I'I' F'EE �r�LC'L1I.t�TIOI�'(S) <br /> 2002 State Statute ❑ �'es This Sec�ion Appiies <br /> The replacement af a Residential fi�ture or a liance that meets all three of the foIlowing requirements: <br /> 1) Does not require modification to elech-ical or gas service. <br /> 2} IIas a total cost of$500.00 or less; excltidin� 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 Permit $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee $ L�0 <br /> If above does not apply, follow guidelines below: <br /> 1. �o�ata-aet �'a-ice" is .0125% of job with a i�inimum Fee of(�35.0(3) <br /> �CCx^•.��� x .0125 $ ,-�',.�- <br /> (contract price) (minimum$35.00) <br /> 2. State Surchar�e. *r Add the State Building Code Division a Minimum Fee of($ .50) <br /> ��a.;.� .: x .0005 $ _ � JZ, <br /> (contract price) (minimum$ .50) � <br /> 3. �'Qstage and �iandlin� (Oszfy nzai!-i�i applicatiorzs) $ � <br /> 4. 'I'O'�'AL. �3�I�1'i1I�' FEI; {Add lines 1-3 above) � ���`� <br /> *CONTRACT PRICE or JOB COST mcans the actual or estimated dollar amount charged for the permitted work including <br /> materials,labor, profit,and otller 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 p3rty the reasonable market value of such items <br /> must be added to the estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the amount of <br /> thejob cost,the City may request the submission of a siancd copy of the actual contract. <br /> **The STATE SURCHARGE is.0005 of the contract price under$I,000,000 or�.50-whichever is greater.For valuations over <br /> �I,000,000 cafl the Department of Inspectional Services for the price. <br /> "l�he undersigned hereby applies to the City for issuance of a Nlechanical Pern�it,agrees to do al]work in strict accordance with <br /> the ordinances of the City and the regula[ions of the Minnesota State Building Code,and certifies lhat al]statements made on this <br /> application are complete, true and correct. <br /> / <br /> Applicant's Signature: ' - �y. Date: 1) � <br /> Approved By: I Date: <br /> � i <br />