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, . , <br /> � PERMIT-FEE��AI.CULATION(S) .'�� ���'� � '� � <br /> �, BASED OFF -2002 STATE STATUE` ':° ' ;` V ��' <br /> � „�� <br /> :. . <br /> ?Y <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;excludin�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 Fce � <br /> ��' � ��� ����� � �PERMIT�FEE�CALCULATION S �-�J(OBS�OVER$500:00 � <br /> �� �` <br /> If above does not apply;follo�v guidelines below: <br /> 1. CONTRACT PRICE * is 1.25°/o of contract rice with a(Minimum Fee of$35.00) <br /> � ��,},�.� <br /> ��� ,_s�� <br /> — _ X .oizs $ <br /> (contract price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fce of$.50) <br /> x .0005 $ <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ;, ,,'. '=''':� <br /> ' * CONTRACT �RICE 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 far issuance of a Mechanical Permit, agrees to do all <br /> work in strict accordance with the ordinances of the City and thc regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> ? <br /> � / ,; <br /> Applicant's Signature: ' �.� /���j� /�/��- Date: J ��7'0�� <br /> , �'�=� �-� _ <br /> Reset Form v 1Ci D <br /> 3 , , 3 �� _ � <br /> � �� s �/ <br /> Cry <br />