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PfiRMIT FF,E �ALCLJLATION(S) � � <br /> 2d02 St�te Statute ❑ Yes This Section Applies <br /> The replacement of a Residential�xture or ap�liance that meets all three of the following requirernents: <br /> 1) I)oes not require modification to electrical or gas service. <br /> 2) Has a total cost of$�00.00 or less; excludin�the cost of the fixture or agp3iance: <br /> and <br /> 3) Is improved,installed or replaced l�y the homeo�vner or licensed contractor. <br /> 5kip next section; Cost of Permit $ 15.00 <br /> State Surcharge$ .50 <br /> . MaiI-In Fee $ 1.50 <br /> If above does not apply,follow guidelines below: <br /> 1. �'antract Price* is A125% of job with a Mir�irnum Fee of(�35,Q0) <br /> 0�.3�(o�J� x .0125 � 4�8�s� <br /> � (contract price) (minirnum�35.00} <br /> 2. State Surchar�e. ** Add the State Building Code Division a Minimum Fee of(� .50) <br /> o�.��, (°OJ"� x .0005 $ �/S 8a <br /> (contract price) {m'rnimum 5.50) <br /> 3. P�sta�e and Handlin� (OnCy mail-i�e applrcatior�s) $ 1.50 <br /> �. TOTAL PERMIT FEE (Add lines 1-3 above) $ J��a ?� <br /> *CON'I'RACT PRICE or JOB COST means the accual or estimated dollar amount charged far the permitted work including <br /> materials,labor,prof t,and other fixed costs. It is the amount ta be charged to the cusromer for the work done. If any material, <br /> �;quipment,labor,or instailation is furnished by the owner,tenant or any other party the reasonable market value of such 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 the amount of <br /> the job cost,the City may request the submission of a signed copy of the actual contract. <br /> **The STATE SURCHARGE is.4005 of the contract price under�l,000,000 or�.50-whrchever is greater.For valuations aver <br /> �i,f70Q,�Q0 cail the 1�e�artment of fnspectional Services for the price. <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit,agrees to do all work in strict accordance with <br /> the ordinances of the City and the regulations of the Minnesota State Building Code,and certifies that all statements made on this <br /> application are complete,true and correct. <br /> Applicant's Signature: Date: �l/S 4y <br /> Approved By: Date: <br /> 3 <br />