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. � . <br /> " �� � PEt�VIIT����EE����CALCCILATIC)I�I{S} � <br /> B�1SED Q�F - 2�lOZ STA'TE STA7'UE I <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�as service. <br /> 2. Has a total cost of$500.00 or less;excludinQ the cost of the fixture or appliance:and <br /> 3. ls 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) $ L50 <br /> Total Permit Fee $ <br /> , .,;.K;� ;;���; •'�"'_ <br /> . _ <br /> . <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 /> p0 <br /> I�Oo . X.0�25 � ��5� � <br /> (contract price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of 5.50) <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 /> ■ * CON'I'RACT 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 fumished 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 Buildine Department at(952)249-4600 for the price. <br /> ��� � �" r�"`�;G�:ANICALT'ERM�'T`;AP1'LICATIt�N AGI�EEMENT" "' `" � <br /> .� �. �_.,,..�.. � .�,;�: <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 certifies that all statements made on this-�application are complete, true and <br /> correct. <br /> Applicant's Signature: ` Date: � � � I � � � <br /> K�� � �� <br /> � � ��- Res�t Form ` <br /> �� _... .�� �;: <br /> 3 <br />