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� PERiV1I�1' FEI���CAL,CULn"�(Qi '(S) <br /> I--_ _T3A5ED_OFF - 2002 STA"T�F' STATUE, , , <br /> ❑ Yes,this section applies <br /> 't'he repllcen�ent of a Residential fixture or appliance that n�eets all three�>f the fo(lowiaig requirements: <br /> I. Does not require modification to electrical or`�as scrvice. <br /> 2. Has a total cost of$500.00 or 1ess;excludin�the cosl of the fxture or appliance: and <br /> 3. Is improved, installed or repl�ced by ihe homeowner�r license:� contractor. <br /> SI<ip next section, if this applies; Cost of 1'ermit � (j.�p <br /> State��urchar�e `� .50 <br /> Maii-]n F�e(Ifnpplicable) $ 1.50 <br /> 'I,otal t'ermit Fee � <br /> ____ PER�VfIT FEE CALCL"LATION�S�_.iOBS OVER$500.00 ' <br /> I f above does not apply;follo���guidelines below: <br /> 1. CONTRACT PRICE `e is I.?5%of conU�act��rice�vith a (Nlinimum �e o �35.00L <br /> n � ,yo � �-f� <br /> � x .012�$ . <br /> (con act�n iccj —(miniinum$3�_00) <br /> 2. STATE SURCIIARGG "`Y Add the State B{cl�,Code Div. Surcharge(Minimun,fcc of'F.5(I) <br /> _� � °p `� <br /> � ���/_v_ `� . .noos �-- � <br /> (CnliLr:tct )fICC) � � <br /> I y- (minimum`ri 50�) <br /> 3. POSTAGE& HANDLIN(; (Only on Mail-In A��plic�tions) �, �.5p <br /> 4, TnTAL PERMiT FGE(Add I,ines I-,/�bove) � • �� <br /> ^ �' CONTRACT PRICE; or JOB COST means the ac{ual or escimated dollar amount charged for the <br /> permitted work including materials, labor, profit, and other fixed costs. )t is the amount to be charged <br /> to t:he customer for the �i-orl: done. If any material, equipment, labor or installations are furnis6ed by <br /> the owner, tenant or any �ther party, tlle rcasonable marl<et vahie of such items must be added to tlie <br /> estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the <br /> amotmt of the.job cost, the City may request the submissi�n of� signed copy of the actual contr�ct. <br /> a '�`The STATG SURCHARGG is .Q(l0i of the Buildin�; Department at(952)2q9-4600 for the��rice. <br /> MF,C'HA'�ICAI. P_F_.RM1T,�PPi�'(('A T'InN n(�rRFF;nnF1�iT '--1 <br /> - -- -- -- --- -- ------- - ---J <br /> The undersigned hereb�� applies io the City for issuance of a Mechanical Permit, agrees to do all <br /> c�vorl< in strict accordance with tlae ordin�i�ces o� tl�e City and the rc�ulations of the State of <br /> Mii�nesota; and certifies that �_II statemenYs macle �n this application are complete, true ancl <br /> c:�rrect. <br /> ,\��plicant's Signature: � ' Date: '� V <br /> - -------- ----- __ <br /> — � � �_ � .___. <br /> Sf t f�1C�sn <br /> � <br /> .� <br />