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• f::��,>.. -----'----'�-----------i <br /> � PERMIT FEE CALCULATION(S) � <br /> ��`�' ' BASED OFF-2002 STATE STATUE � <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance that meets all tluee of the following requiremenls: <br /> 1. Does not require malification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excluciinQ the cost of the fixture or appliance: and <br /> 3. Is improved,installeci or replaced by the homeowner or licensed contraclor. <br /> Skip next seclion,if this applies; Cost of Permit $ 15 lr) <br /> State Surcharge �____5t� <br /> Mail-In Fec(If Applicable) $_ 1.50 <br /> Total Permit Fcc � <br /> , PERMIT�FEE CALCULATION(S)-JOBS`O�ER$500:00 _ __ <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE 'is 1.25%of contract price wilh a(Minimum Fcc uf�35.00�. <br /> ' �% �� <br /> � � S tJ�� X.o�zS� � � --- <br /> (contract price) (miuimum b.Z5.00) <br /> 2. STATE SURCHARGE *'Add the State Bldg Code Div. Surcharge(Minimum I�'ee uf 5.50) <br /> �� . ��` <br /> � � `'��� � x.o(�5 g �� <br /> (contract price) (minimum S .50) <br /> 3. POSTA('�F_;&HANDLING(Only on Mail-In Applications) $_ 1.50 ___ <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) � ' ��,�_� <br /> ■ • CON'I'RACT PRICE or JOB COST means the actual or estimated dollar a�uount ch�rge�l li>r thc <br /> permitted work including materials,labor,profit,and other fixed costs. It is the amotuit to be c:harE,ed <br /> to the customer for the work done. If any matenal,equipment,labor or installaticros arc fiimislied b�� <br /> the owner,tenant or any other party, the reasonable market value of such items must be acidcd t�� Il:c <br /> estimated cost or contract price for permit fee pucposes. In tlle event that tlierc is ,� dis��ute �>n (hc <br /> amount of the job cost,the City may request the submission of a signed copy of thc actuai conlraat. <br /> ■ *�`The STA'TI; SURCHARC'lE is.0005 of the Building Department at(95?)249-46(l�f��r�hc liri�•�c. <br /> - MECH.ANI�AL1'ERMIT APFLICATTON AGREEMENT � <br /> The undersigned hereby applies to the City for issuance of a Mechatiical Permit, agrecs to �lu .�il <br /> work in strict accordance with the ordinances of the City and the regulations ol' thc Stalc of <br /> Minnesota, and certifies that all statements made on this application are complete, truc ancl <br /> correct. <br /> , <br /> � � ��_ \ — <br /> Applicant's Signature�� � �r�1 Date: \ , � r <br /> Reset Form <br /> 3 <br />