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� � � �� � � � � E'ERMI'C FEF CALCULn"I�I�ON(S) � � � <br /> j_ BnSEn OFF - 2002 STA"I't� STATUE <br /> ❑ Yes,this section applies <br /> i'he replacement of a Residential fixture or appliance th�t meets all thrce of the following reqt�irements: <br /> I. DoEs not require modification to electrical or�as service. <br /> �. Has a total cost of$500.Op oc less;excludin�the cost of the fixture a�appliai�ce:anci <br /> :i. Is improved, installed or replaced hy the homeowner or licensed contractor. <br /> Skip next section, if'this applies; Cost�f 1'ermit $ �j.pp <br /> Siate Surch�rge $ .SO <br /> Mail-In 1'ce(If'npplicable) $_---1.50 <br /> 7btal Per►nit Fee $ <br /> �_ PERMIT FEE CALCL;LATION�S)-.IOBS OVER$SOOA� '' �_I <br /> I Cabove does not apply; follow guidelines helow: <br /> 1. CONTRACT PRICE 'k is I.?5°/„�f contract price�vith a(Minimiim Fee af$35.Of►� <br /> � L <br /> � x .012� $ ����----- <br /> {cnn(.�cC pricc I (m��um$��.00) <br /> 2. S'I'ATE SURCIIARGE "`* Add the State� E31d�C'oc(e Div.Surcharge(Minimum h'cc of�.SU) <br /> � � " �'� �� <br /> ---(c�rac��_�t x .0005 $ � • / <br /> -- --- <br /> I �'�'�) (minimum$ SO) ---- <br /> 3. POSTAGE& HANDLIN<<(Only on Mail-In Applicationsl $__ I.50 <br /> �� <br /> 4. �fnTAL PERMIT I�GE(A<id Lines I-3 nb�ve) � , �� <br /> ^ "' CONTRACT PR�CE? or JOB COS'1' means the actual or estimlted dollar amount charged for the <br /> permitted work inclu.�ing materials, I�bc�r, profit, and othcr tixed costs. ]t is the anlouilt to be cl�arged <br /> to the custon�er for the ��vork done. If any tnaterial, equi��mcnt, labor or installations are furnished by <br /> the o�vner, tenant or any other paily, the reasonable n�arl:et v<�lue ol�such items must be added Cp the <br /> estimated cost or co��tract price for permit fee pur��oses. In the event that there is a dispute on the <br /> atnount of the job cost, the City inay request the submission of a signed copy of the actual contract. <br /> ■ ����The STATG SLiRCHni2GE is .0005 of the Buildin�;Departmenl at(�)52)249-4C00 Por the price. <br /> �� � MECH�NIC'AL PERMIT APPLICATION AGREF.MENT � <br /> -------- ----- ---------------- ----- -- -� <br /> 1'he undersigned herehy applies to the City for issuance of a Mechanical Pet�mit, agrees to do all <br /> ��vork. ii� strict accordance with the ordinances ol� the City and Cl�e re!�ulations of the State oi� <br /> f�linnesota, anc( certities that all statements made on this ap��lication are complete, true and <br /> correct. ', <br /> / j�� � �1� <br /> A��plicant's Signature: �__--- l 1"�'' — -- �� DaCe:� ��`� --- <br /> � Sf t f tlCj�sn � � <br /> � <br /> _> <br />