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� ��;1��ilT r�,�, c.�Lcvi._�rlo���s�-- <br /> � �3_LSED O�F — 2002 STrLT�; S`1����'�U�;� �� <br /> ❑ Yes,this sectioil applies <br /> The replacement of a Residential Fixture or a�pliance that meets all tlu�ee of the following requirements: <br /> 1. Does not require modification to elech-ical or gas service. <br /> 2. Has a total cost of�500.00 or less; escludin� 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 $ 15.00 <br /> State Surcharge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee � <br /> #::` PERIVIIT FEE CALCULATION(S) —'JOBS OVER$500'00 <br /> If above does not apply, follow guidelines below: <br /> � 1. CONTRACT PRICE * is 1.25%of contract price with a (Minimum Fee of$35.00) <br /> � <br /> � �� � x.0125 $ � <br /> ( ntract price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge (viinimum Fee of�.�0) <br /> x .0005 $ <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE&HA�IDLNG(Oz�ly on Mail-In Applications) $ 1.50 <br /> 4. TOTAL PERI�IIT FEE (Add Lines 1-3 Above) $ <br /> ' * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor,profit, and other fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material, 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 price for permit fee puiposes. In the event that there is a dispute on the <br /> amount of the job cost, the City may request the submission of a signed copy of the actual contract. <br /> • ** The STATE SURCHARGE is .0005 of the Buildin�Department at(9�2) 249-4600 for the price. <br /> NIECHANICAL PERIv1IT APPLICATION;AGREEMENTs , , i ' - <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all state ts mad ory'this application are complete, true and <br /> correct. / / <br /> i <br /> /, J, <br /> Applicant's Signature: -�"��� --'� <br /> Date: <br /> `� <br /> � <br /> 3 <br />