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� �� . <br /> � <br /> �'ERIVFIT FEE �'ALC�,TLA.TI�N(S) <br /> 2002 State Statute ❑ 'Yes This Section A�pfies <br /> The replacement of a Residential fixture or a�pliance 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: <br /> and <br /> 3) Is ir-nproved, installed or replaced by the homeowner or licensed contractor. <br /> Skip next section; Cost of Permit $ l 5.00 <br /> State Surcharge$ .50 <br /> Mail-In Fee $ L50 <br /> If above does not apply, follow guidelines below: <br /> �• Coa�traet �'P-i�:e* is .0125°io of job with a lp,'Iiranlum �'ee� of(�3�.00) <br /> _ �J�Oc;.,>,, x .0125 $ __ (O `. /j_ <br /> (contract price) (minimum�35.00) <br /> 2. Sdate SurcB�artre. *� A.dd the State Building Code Division a 1Vli�imnm Fee of(� .50) <br /> _�,/CJ � _�; X .00OS � �' JS <br /> (contract price) (nunimum$ .50) <br /> 3. �c�sta�e a�d Handiin� (�rtly nzail-i�r applicatiorzs) � _ �.�--� <br /> s�.�-. <br /> �. �'��'�.L �'��I�' ��E (Add lines 1-3 above) � �,�, ��'_, <br /> *CONTRACT PRICE or JOB COST mear,s d1e actual or estimated dollar amount charged for the permitted worl<including <br /> materials,]abor,profit,and other fixed costs. Tt is the amount to bc charged to the customer for thc worl<done. If any material, <br /> cquipment, labor,or installation is fumisned by the owner,tenant or any other party the reasonable market value of sucti items <br /> must be added to the estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the amount of <br /> the job cost,the City may request the submission of a si�ned copy of the actual contract. <br /> **The STATE SliRCHARGE is.0005 of the contract price under S I,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 Pem�it,agrees to do all work in strict accordance with <br /> the ordinances of the Ciry and the regulations of the Minncsota State Building Code,and certifies that all statements made on this <br /> application are complete,true and correct. <br /> Applicant's Sign�ture: . e —i — Date: �/ �- <'i- � <br /> Approved By:;' e� Date: <br /> 3 ' <br />