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� 1` <br /> � PER_ti�ilT FEE CALCUL�TIO�±(S) <br /> � BASED OFF - 2002 STATE STATliE <br /> ❑ Yes, this section appfies <br /> The rzplacement of a Residentiaf fi.Yture or appliance that meets all three of the followin;requirzments: <br /> 1. Does not require modification to electricai or gas servicz. <br /> 2. Has a tota( cost of 5�00.00 or less; excludina the cost oi the tixture or app(iance: and <br /> 3. [s impro�ed, fnstalled or replaced by the homeowner or licznsed contractor. <br /> Skip next section, if this app(ies; Cost of Permit � L�.00 <br /> State Surhar�e � .�0 <br /> titail-In Fee(If.�pplicable) � 1.�0 <br /> Total Permit Fee � <br /> �I PER�tiiIT FEE C�LCliLATIO�r(Sj -JOBS 0�'ER$�00.00 , <br /> IT abo��e does not appiy; foilow�uid�lines below: <br /> 1. CO�TR.�CT PRICE * is l.'���o of contract price with a(�finimum Fee of�3�.00) <br /> L�J��� C?� x.O1_'� � S�• �c'�S <br /> lcoiitract pnce) �minimum 33�00) <br /> ?. ST.aTE SCRCH_�RGE *" :�dd the State Bld�Code Div. Surcharge (�tinimum Fee of�.�0) <br /> zu�s�_ � X o�o� � 1� . ��- <br /> {con[ract pnce) (minimum� �0) <br /> 3. POST.�GE & H.�NDLING(Onfy on '�Iail-In Applica�ions) �_��... <br /> �. TOTaL PE2�i[�I' FEE (.add Lines 1-3 Above) � ��� ' � <br /> • * CONTR.-�CT PRICE or JOB COST means the actual or zstimatzd dollar amount char�ed for the <br /> permitted work includin� matenals, labor, profit, and other fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any matzrial, equipment, labor or installations are furnished 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 pnce 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 submi�sion of a si;ned copy of the actual contract. <br /> � **The ST.-�T'E SURCH.aRGE is .000� of the Building Department at(9�?) 2�9-4600 for the pnce. <br /> � MECHANICAL PERib1IT APPLICATIOIv� AGREEVIENT <br /> The undersigned hereby applies to the City Por issuance ot a Mechanical Permit, a�rves to do all <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> �Iinnzsota, and certifies that all �tatements made on this application ar� complete, true and <br /> conect. <br /> :�pplicant's Si�nature: ;�Q._ �' Date: �j - �j -��j <br /> , <br /> � <br />