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�� � ____ � <br /> I r 1 <br />;" I <br /> i I <br /> 6' <br /> I <br />� � I <br /> I <br /> p '� �1 � <br /> � <br /> PERNIIT FEE CALCULATION(Sl �,, <br /> 2002 State Statute �Yes This Section Applies <br />, ; <br /> The replacement of a Residential fixture or a�liance 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: � <br /> r and � <br /> 3) Is improved,insta.11ed or replaced by the homeowner or licensed contractor. � <br /> i <br /> Skip next section; Cost of Pemut $ 15.00 � <br /> F State Surchazge$ .50 i <br />� Mail-In Fee $ 1.50 <br /> k <br />� <br /> If above does not apply,follow guidelines below: ! <br /> 1. Contract Price*is .0125%of job with a Minimum Fee of($35.001 <br /> � <br /> x.0125 $ I <br /> (contract price) (minimum$35.00) <br /> ' I <br /> 2. State Surcharse.**Add the State Building Code Division a Minimum Fee of($.50) ; <br /> I <br /> x.0005 $ <br /> (contract price) (minimum$.50) � <br /> � <br /> 3. Postage and Handlin�(Only mail-in applications) $ 1.50 , <br /> i <br /> � <br />„ 4.TOTAL PERMIT FEE(Add lines 1-3 above) $ ! <br />` I <br /> I <br /> •CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including I <br /> materials,labor,profit,and other fixed costs.It is the amount to be charged to the customer for the work done.If any material, <br /> equipment,labor,or installation is furnished by the owner,tenant or any other pazty the reasonable market value of such items <br /> must be added to the estimated cost or contract price for pernut fee purposes.In the event that there is a dispute on the amount of i <br /> the job cost,the City may request the submission of a signed copy of the actual contract. I <br /> •*The STATE SURCHARGE is.0005 of the contract price under$1,000,000 or$.50-whichever is greater.For valuations o�-er <br /> �1,000,000 call the Departrr►ent of Inspecrional Services for the price. - <br /> The undersigned hereby applies to the Ciry for issuance of a Mechanical Permit,agrees to do all work in strict accordance with I <br /> the ordinances of the City and the regulations of the Minnesota State Building Code,and certifies that all statements made on inis i <br />` application are complete,true and correct. j <br />� ? I <br /> i <br /> , � <br /> � <br />� <br />� Applicant's Signature: Date: 1 Z � D � <br /> Approved By: Date: <br /> 3 ' <br />, ; <br />�. <br /> J <br />�__,._._.._ _.._ _.._� _. _ _ _..�_. _ ,._._ __ _ LL- -- - - -- �....__...�..� _.. <br />