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i___--- — _ _ __ <br /> � P�RMIT I'EF CnLCUL�ITION(S� ' <br /> �_ 13�1SL'D Ol�l� ''(�OZ STATE STATUL � � �� � <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;excluding 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) $ L50 <br /> Total Permit Fee $ <br /> _ � . � ,� ,��� � � �. <br /> ; � : ; _ <br /> F �.. � <br /> � �� <br /> =,._. ,__ ,..._ ,: _.:�_. . r �'. .__ � ��:" <br /> x �:.. <br /> �.. . .�. <br /> y= <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 /> 5,900.00 x .0125 $ �3.75 <br /> (contract price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of�.50) <br /> 5,900.00 x .0005 $ 2.95 <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE& HANDLING (Only on Mail-In Applications) $ 1.50 <br /> 78.20 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> ■ * CONTRACT 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 /> ■ ** 'I'he STATE SURCHARGE is .0005 ofthe Building Department at(952)249-4600 Tor the price. <br /> �:, � °�� ;' �� ,. <br /> „ n„� �", ta d��� <br /> ,_ , � �`�j e �9i� ,,,.. .�� � ^Y rY��w.m�,i �i C;,, <br /> � F <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 /> � ^ <br /> ii; � e� <br /> Applicant's Signature: ` � '�� Date: `� a�3 �'O <br /> Reset Form <br /> 3 <br />