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� __ _PL;RMIT I FF� ('-ALGULATION(S� __ <br /> � a,4Sf�D OFF 2002 S"1'A I�� STnTUC <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or ap�liance that meets al1 three of the followin�requirements: <br /> 1, Does not require modification to elech�ical or�as servicc. <br /> 2, Has a tota.l cost of$500.00 or less;excludin:the cost cif the fixture or appliance: �nd <br /> 3. ls improve�i, inst�lled or replaced by the homeowner or licensed contractor. <br /> Skip next section, if this applies; Cost of Pennit � 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(ff A��plicable) $ I.50 <br /> Total Permit I�ee $ <br /> � _ ' PEI�MITFEE CALCULATION(5)-.(OB'S OVER $5(�0.00 <br /> !1'above does not apply; follow guidelines belo�v: <br /> I. CONTRACT PRICE * is 1.25%of contract price with a(Minimnm Fee of$3S.OQ) <br /> I �� b� <br /> 1� x .0125 $ I�� . <br /> (con ractpricc (minim�nn'�3i3O�) <br /> 2. STATE SURCHARGE '�* ndd the State Bldg Code Div. Surcharge(IVtin'mum Pee of�.50) <br /> � t <br /> �� � l <br /> �� x .0005 $ '� <br /> — -r-- <br /> (confra pricc) (minimum$ SQ) <br /> 3. POSTAGE&HANDLING (Only on Mail-In Applications)� $ I.50 <br /> 4. '1'OTAL PERM[T FTF(Add Lines 1-3 Above) � <br /> b 0 .a� <br /> • `� CONTRACT PR]CF, or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor, profit, and other fixcd costs. It is tlie amount to he cllarged <br /> Y�the customer for the work done. If any material, equipment, labor or installations are fiu-nished by <br /> the owner, tenant oi� 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 clispute on the <br /> amount of the_job cost, the City may request tl�e submission of a signed copy of the actual contract. <br /> ■ �`*The S"f ATF_, SURCHARGE is .0005 of the 13ui1din�Dcpartment at(9_52)?4�-4600 for the price. <br /> �_ , MECHANICAL PERMIT APPL[CATION AGR�EMENT <br /> The undersi�ned hereby applies to the City for issuance of'a Mechanical Permit, a�i•ees to do all <br /> ���ork in strict accordance with the ordinances of the City and the regulations ofi the State of <br /> Minnesota, ancl certifies that all statemei�ts made on this applic�tioi� are complete, true and <br /> c�rrect. <br /> npplicant's Signature: _ Date:-v_�L�(Z_-- <br /> Reset Form <br /> 3 <br />