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i <br /> � ' , � <br /> �� " �; �` " �PERMIT�FEE �ALCULATION(S) �'� <br /> . . <br /> '; � i: ,'` ;,�: '' BASED OFF -2002 STATE STATLTE� ' __ —_--- -:_ _ <br /> �] Yes,this section applies <br /> Tlle replacement of a Residential fixture or appliance that meets all three of tl�e tollowiii�;reyuirr,n�,e^i7ts: <br /> 1. Does not require inodification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excltidinQ the cost of the fixtt�re or appliance: ar��"• <br /> 3. Is improved, installed or replaced by the homeowner or liceused contr<u:tuc. <br /> Skip uext section, if this applies; Cost of Pernut �.----'��'����� <br /> State Surcharge � _- 5�� <br /> Mail-Ll Fee(If Applicable j � .__ _ � :?'� <br /> Total Permit ree �._ _ <br /> ___ —_ � <br /> � `'PERMIT FEE CALCULATION(S)-:70BS OUER $500 00_� . _ _ , <br /> If above does not apply; follow guidelines below: <br /> 1. CON7'RACT YRICE * is 1.25%of contract price with a(l�Iinimuin Eec of$35.�ill <br /> 3�y/ � x.0125x____ _:/ _✓_/_______ <br /> (coniract pricc) (mininwm Q�"4'�OU) <br /> 2. STATE SURCHARGE ** Add the State Bldg Code Div. Stu�charge(Minimum 1�'er:of�.50) <br /> �Ll G1/ � x.0005 �_ ___.___�_'� <br /> ___ _---- <br /> (contract price) --�- (mioin�wm`� iU) <br /> 3. POSTAGE&HANDLiNG(Only on Mail-In Applications) `� _.._.__,___. � '>`� <br /> � y, <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) �_..__./--. ----------- <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated clollar amount char+;ed ibr the. <br /> pernutted work incl�iding matenals, labor,profit, and other fixed costs. (f is tl�e amount tn hc char};t�l <br /> to the customer for the work ctone. If any material, equipment, labor or installations arc f'i�rnished b�� <br /> the owner, tenant or any other party, the reasonable market value of'sucli iteir�s Tnust he� ,�tidrd tn ll�c <br /> estiulated cost or contract price for permit fee p�itposes. Tn the r,vent that th�;rc is a di��,�iute on tl�r <br /> c'tiiii3tlt'ii Of ji1C�027 COSC, i}10 Cktj� 2�13}� iCQU05t ��lC SLl�J1111S51OTl Jf �l 8��11e`j C`1�7;� C?� ��1!' £?+�'1�!:il rr,i2lr�,ir�_ <br /> ■ *� Tl�e STATE SURCHARGE is .0005 of the Building Departmcnt at(952)249-4G00 lix t1.c j7ricc. <br /> �_- -- -- _..t <br /> MECHANICAL PERMIT APPLTCATION AGR�ENIENT_v _ ___ __ i <br /> �- —__ ---_ .. <br /> The undersigned hereby applies to the City for issuance of a Mechanical Pcrmit, agrees to do all <br /> work in strict accordance with the ordinances of the City ��1d the �regulatioiis of tl�t� Statc of� <br /> Minnesota, and certifies that all statements made on this �pplication are compl��i{�, iruc; and <br /> correct. <br /> ��" � <br /> Applicant's Signature: I)atc: ________ <br /> � <br /> 3 <br />