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_ � P�ru�t�T����EE c��LCUL�Tlo�v�s):= , <br /> . :< ,:= , < _ '`BASED.OFF� �00� � <br /> _ � STI�TE ST=IT.UE �"� <br /> ❑ Yes, this section applies <br /> The replacement of a Residential fixture or a liance 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�g the cost of the fixture or appliance: and <br /> 3. Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip next secrion,if this applies; <br /> Cost of Permit $ 15.00 <br /> State Surcharge $ .50 <br /> Mai1-In Fee(If Applicabiej $ 1_50 <br /> Total Pernnit Fee � <br /> � �, <br /> ������F�„'����;�=���PERMIT;F'EE CALCTULA,`�IO F" �` z;��.�. <br /> . . N3(��:-�`�7�3��OYV,�R��SOb Ob����t,�'"� �,^�,� <br /> . . .. � _ <br /> If�above does not apply; follow guidelines below: � <br /> I• CONTRACT'p1uCE * is 1:25%of contract price with a (Minimum Fee of$35.00) <br /> � O <br /> __��x .0125 $ <br /> (c �tract price) (minimum 53�.00) <br /> �- S1�A`l'.'�;S�1RCrIr�GE *� � <br /> Add the Sta�e Blrl�r r'nrle [�i�;. S„��!�ar^� (,lFi� <br /> � .i1:ilU�t7�eC Ji�.JD) <br /> �----__—.—_ X .�0�5 � <br /> (�0:.`,a:..D,-�Ccl _ <br /> /-., _ <br /> 3. POSTAGE& HANDLING (Only on�4ail-In ���plic�r��ii�; � � . �.;_�� ��� <br /> ---1-��-- <br /> 4. TOTAL PERIVIIT FEE (Add Lirtes 1-3 Above) <br /> � <br /> ' * CON'I'RACT pRICE or JOB COST means the actual or esrimated dollar amount charged for the <br /> Perrrutted work including matenals, 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 fiu-nished 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 perrriit fee purposes. 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 Building Department at(952) 249=4600 for the price. <br /> ���`�,�-�::r��1 � �`�-NIE,CHANIC £ <br /> .s,�.:. � AT,I'ER�IIT���L����'����4'����l�I,E� ����'�� f��` n .�;., <br /> ..... .. ... x..�'.:� '��r� _�: <br /> . . _�.3,..�... <br /> The undersigned hereby applies to the City for issuance of a Nlechanical Permit, agrees to do a11 <br /> work in sfict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all st en made on this application are complete, true and <br /> correct. � <br /> i i � <br /> �� <br /> Applicant's Sib ature: � <br /> Date: `�� ' Z <br /> 3 <br />