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. + <br /> �EI21l�IT F�E CALC�,TL�TI�N(S) <br /> 2002 State Statut� ❑ Yes This Seetion�.ppiies <br /> Th�replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> ]) 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 homeo�ner or licensed contractor. <br /> Skip next section; Cost of Permit $ I 5.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee $ 1.50 <br /> If above does not apply, follow guideiines below: <br /> 1�. �ontr�ct �'r-i�e* :s .0125% of job with a 1l�inim�:n �'ee o4�(�35.00) <br /> ,,. - <br /> �� C�-::-� � x .0125 � _�.�, <br /> (contract price) (minimum�35.U0) <br /> 2. �5tate Surchar�e. **Add the State Building Code Division a 1�7ira�rne�m Fee of($ .56) <br /> J i;�'�_ ;a, _x .0005 $ . C. �, <br /> (contract price) (nunimum n .50) <br /> 3. �'os�a�e and �IandIin� (O�idy raa�i!-irt applic�atiorrs) � •�-- <br /> 4. '�'��'�]L ��;���I�' ��� (Add lines 1-3 above) � .�� �`, <br /> *CONTRACT PRICE or JOB COST means the actual or estimated dollar amounC charged for the permitYed worlc including <br /> materials,labor,profit,and otl�er fixed costs.It is the amount to be charged t�o the customer for the work do�e. If any material, <br /> equipment, labor,or installation is fumisned by the owner,tenant or any other party the reasonabfe market value of such items <br /> must be added to the estimated cost or contract price for permit fee purposes. ln the event that there is a dispute on tne amount of <br /> thejob cost,the City may request the submission of a siened copy of the actual contract. <br /> **The STATE S�RCHARGE is.0005 of the contract price under�1,000,000 or$.50-whichever is greater. For valuations over <br /> $1,000,000 call the Department of Inspectional Services for the price. <br /> The undersigned hereby applies to the City for issuance of a Mechanical Pemiit,agrees to do all work in strict accordance with <br /> the ordinances of the City and the regulations of the i�iinnesota State BuildinJ Code,and certifies that al]statements made on this <br /> application are complete,true and correct. <br /> �� <br /> � <br /> Applicant's Signature: ����'-Zu�- �� �ti�,7�;_ Date: ��)���6 <br /> Approved By: Date; <br /> 3 ' <br />