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' 3 � PERMIT FEE CALCULATrON(�) ': <br /> ' B��.SED OF'� - 20()2 STATE STATI..IE <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture ar.��y�ii:ince that meets all three of the following reyuirements: <br /> I. Does not require modification to elcctrica(or gas service. <br /> 2. Has a total eost of$500.00 or less:excludin�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; C:ost of Permit � 15.00 <br /> State Surcharge � .50 <br /> Mail-In Fee(If Applicable) S l.50 <br /> Total Permit Fee $ <br /> PE�IT FEE CALCULA�[tON(S)—JQB����ER$500.04 <br /> If above does not apply;follow guideliiies belo�s: <br /> l. CONTRACT PR10E * is I.25°i�of contract price with a(Minimum Fee of$35.00) <br /> 13,380.OU x.0125$ 167.25 <br /> (cuntract pricc) (minimum$35.00) <br /> 2. STATE SURCHARGE **A�ld!hc State Bldg Code Div. Surcharge(Niinimum Fee oT$.50) <br /> �3,35400 x.0005 $ 6.69 <br /> -------- -- <br /> (con:ract pricc) (miuimum$ .50) <br /> 3. POSTAGE&HANDLING(Only oi� Mail-In Applications) $ ___ 1.50 <br /> 175.44 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> ■ * CONTRACT PRICE or JOB COST i»rans ttie actual or estimated dollar amount charged for the <br /> permitted work including materials, labur, ;�rofit,and other fixed costs. It is the amoimt to be charged <br /> to the customer for the work done. lf any material, equipment, labor or installations are furnished by <br /> the owner, tenant or any other parly, chc reasonable market value of such items must be added to the <br /> estimated cost or contract price for permit fee purposes. [n the event that there is a dispute on the <br /> amount of the job cost, the City may request N�e submission of a signed copy of the actual contract. <br /> • **The STATE SURCHARGE is.0(i0� uf it�e t3uiiding Department at(952)249-4600 f'or the price. <br /> �SECHANICAL PEIZ1�11T APFLI+CI�T'I��l'A.,�`.�REEMENT' —�.i <br /> . <br /> ----- � <br /> The undersigned hereby applies to the C.ity for issuance of a Mechanical Permit, agrees to do all <br /> wark in strict accordance with tne ordinan�es of the City and the regulations of the State of <br /> Minnesota, and certifies that all stateinents rnade on this application are coinplete, true and <br /> correct. <br /> Applicant's Signature: __ Date: Q Q"a�'"0 <br /> ��set Form <br /> ,,, � <br /> _� � 3 <br />