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f <br /> ' ;��`t�!- �t -4Y,I/tl}`(`4Jt=11`h �{+�PERMIT:FEE CALGCJLATION(S) > ` , .�� ;;=r ; -� � <br /> i.� .� � S ��� k�y�. ti . �tir4 �.��,., t� ;;'tror�1�1 ' ��..�.r 4 <. �F� � =� 1 Ci.f� ��v.�l ✓ ��� � � <br /> � '.,.; ` 4{,`�•�;�'�'n,.;;��� �'_f-�BASED.:OFE;::2002,STATE STATUE ,,. ,� ,_"���- �� .�• .5 '- <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture 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; eYcfudin�the cost of the fixture or appliance: and <br /> 3. Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip next section, if this applies; Cost of Permit � 1�.00 <br /> State Surchar�e � .50 <br /> Mail-In Fee(If Applicabfe) � 1.�0 <br /> Total PcrT�iit Fee S <br /> � - � <br /> PERNIIT FEE CALCUI;ATION(S)=JOBS OVER $�00.00 <br /> If above does not apply; follo�v Quidelines belo�v: <br /> 1. CO�ITR.-�CT PRICE * is 1?�°0 of con[ract price�vich a(�Iinimum Fee of 53�.00) <br /> O � <br /> �a Qod.� . .o��� S � . <br /> '�cqy�v�c:pncc� (min�mum���00) <br /> 2. ST.-�TE SURCH.�RGE " Add che State Bld�� Code Div. Surchar�e (�tinimum Fcc of5.�0) <br /> �� �� � .000� S � .� <br /> (co�tract price) • (minimum� �O1 <br /> 3. POSTAGE R H.�NDLING (Onl�� on i�tail-In Applications) S 1.:0 <br /> -1. TOTAL PER,�IIT FEE (.add Lines 1-3 Above) S � . <br /> • ' CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charQed for the <br /> Ferrrtitted worK includin� materials, laoor, profit, and o[her fixed costs. It is the amount to be cnareed <br /> to the customer for [he work done. If any material, equipment, labor or instal(ations are fumished by <br /> the owner, tenant or any other party, the re�sonable marl:et value of such items must be added to the <br /> estimated cost or contract price for permit fee purposes. In the e��ent that there is a dispute on the <br /> amount of tl�e job cost, the Ciry may request the submission of a si�ned copy of tlie actual contract. <br /> • **The STATE SURCHARGE is .0005 of the Building Department at(952) 2=49-�600 for the price. <br /> - - - : ' MECHANICAL PERMIT APPLICATION AGREEMENT <br /> The undersigned hereby applies to the City for issuance of a Ntechanical Permit, a_rees to do all <br /> �vork in strict accordance with the ordinances of the Ciry and the re�ulations of the State of <br /> Ivtinnesota, and certiFies that all statements e on this application are complete, true and <br /> correct. <br /> ( <br /> Applicant's SiQn ate: �y`� ~ O� <br /> ;;-�. Reset Form�. , � .:�. • . <br /> . . `",,�:. ..:::.:.:.. . .. . .. <br /> -, <br /> � <br />