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. ,+� f <br /> PEIZl��I'�' �'�E �ALCULATIO�(S) <br /> 2,002 Sfate Sta#ute ❑ Yes This Sec�ion Appiies <br /> The replacement of a Residential fixture or appliance that meets all three of the foIlowing 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 /> and <br /> 3) Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip next section; Cost of Pennit � 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee $ I.50 <br /> If above does not apply, follow gurdelinec belew: <br /> 1. �'an�c-ae� I'r-i�eX is .0125°io of job with a l��incrn�m �'ee of(�3�.0� <br /> ���E�c�� c�r� � .ol�s � ��. �-� <br /> (contract price) (minimum$35.00) <br /> 2. State �urchar�e. **Add the State Buildin�Cade Division a lOBir�imum Fee o��($ .501 <br /> � ��1�'�'. �t� x .0005 $ � � ��` <br /> ! �'` <br /> (coi�tract pi-ice) (minimum� .50) <br /> 3. Pos�a�e and �andlin� (O�zly nzai!-i�a ap�dic�tio�is) � �— <br /> _ \ <br /> 4� `�'��'�� ���'�'��`�' ��� (Add lines 1-3 above) � � <br /> �`CONTRACT PRIC�or JOB COST means the actual or estimated dollar amounc chareed for the pem�itted work including <br /> n�a�erials,labor, profit,and oYhcr fixed costs. It is the amount to be char�ed to the customer for the work done.If any ma[erial, <br /> ec�uipment, labor,or ir�stallation is fumished by the owner,tenant or any other party the reasonable market value of sucti items <br /> must be added to the estimated cost or contract price for permit fee purposes. In the event that there is a dispute on tnc arnount of <br /> the job cost,the City may request the submission of a signed copy of the actual contract. <br /> **Thc STATE SliRCHARG�is.0005 of the contract price under$1,OU0,000 or 5.50-whichever is greatar. For valuations over <br /> $],000,000 cal(the Department of Inspectional Services for the price. <br /> The undersigned hereby applies to the City for issuance of a Mechanical Pern�it,agrees to do afl wark in strict accordance with <br /> the ordinances of the City and the regulations of the Mimlesota State Buildin�Code,and certifies that all statements made on this <br /> application are complete,true and correct. <br /> �� <br /> Applicant's Sign ure: E�r,c,��L �J �� D C, ' � - <br /> ,_, atc: � �s <br /> Approved By: � Date: <br /> 3 i <br />