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� � P��(VII'�`FEE CAI�CllLATION(S) � <br /> BASEI�UFF -2002 STATE STATUE <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;excludina 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 Fee $ <br /> °����L��_ ��.�r„�� �`� -�����'.���� �'�.��`��` �<:,.� <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 /> I <br /> � � x.0125 $ '� . �� <br /> (contract price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50) <br /> � �OOD — X.000s $ �, C�(� <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) $ ✓ J '�� <br /> • * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work induding 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 Building Department at(952)249-4600 for the price. � <br /> l�.. :. .:.... . . :���RMIT AP�"�ICATI9N AGREE�iENT " <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 /> I � � <br /> Applicant's Signature: Date: �' d�-0� <br /> L <br /> Reset Form <br /> 3 <br />