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ti <br /> t <br /> � ; :� '�,i�, t'�` jy;�ti s� ° ��"+�PERMIT:FEE,�CALCUL�ATIQN(S)' � ` � ,t�} r „ r �` �'� ; ,, <br /> .,,`.;s'� ,�;,.;�:,�?,�'� `.2 �� y--;-BASED OFF .-2002 STATE STATUE „ . = ._>�� .�r •- <br /> ❑ Yes,this section applies <br /> The replacement of a Residential firture 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; excludin�the cost of the fixture or appliance: and <br /> 3. Is improved, installed or replaced by the homeo�vner or licensed contractor. <br /> Ship next section, if this applies, Cost of Permit � 15.00 <br /> State Surchar;e S .50 <br /> Maif-In Fee(If Applicable) � 1.50 <br /> Total Permit Fee S <br /> - � PERMIT FEE CALCUI;ATION S -JOBS OVER$500.00 <br /> If above does not apply; follow�uidelines below: <br /> I. CONTRaCT PRICE * is 1.?�°0 of contract price with a(i�linimum Fee of S3�.00) <br /> � c�J� .�� � .o��� 5 �J . �� <br /> �(onva�:pncc� (m�nimum 5��.00) <br /> 2 ST,�TE SURCH.-1RGE ** .Add ihe State Bld��Code Div. Surchar«e (�Iinimum Fce ofS.�O) <br /> . � <br /> � ���' � .��0� S r �v <br /> contr�ct price) (minimum S �Ol <br /> 3. POSTAGE 8. HANDL[�IG (Onlv on ltail-In .�pplications) S 1.50 <br /> -1. TOTAL PER;�IIT FEE (Add Lines 1-3 Above) S ��� �� <br /> • ' CONTRACT PRICE or JOB COST means the actual or estimzted doliar amount ch�rged for the <br /> permitted �vork including materials, labor, profit, and other fixed costs. lt is the amount to be char�ed <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 Ihe event that there is a dispute on the <br /> amount of the job cost, the Ciry may request the submission of a si�ned copy of the actual contract. <br /> ■ **The STATE SURCHARGE is .000� of the Building Department at(9�2)249-4600 for the price. <br /> - - ' ' MEC�-iANICAL PERMIT APPLICATION AGREEMENT <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, a�rees to do all <br /> �vork in strict accordance with the ordinances of the Ciry and the regulations of the State of <br /> Minnesota, and certifies that aif statements made on this application are complete, true and <br /> correct. <br /> Applicant's Si�natu • Date: `-'7 � � � � �� <br /> ; � Reset Form� , � , <br /> . `'',',:. _ .. . ._.. . <br /> 3 <br />