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<br /> �����'��Y-���� '`'' P��MI'I�F�CALCI�L�'A�ION(S) ��'~�� � �
<br /> ^ t�- �3 � L: a �:c "- t '�^' , ,.e: ..., +n ��� �2.`!g`y�`'`�..Y s;l{ - a�; .
<br /> ��':��;� ,BASED�OFF =�2002�<S�A�'ES`F�TU� � .�` ' y�$ ` '�{ '�(yk��'{��
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<br /> ❑ :Yes,this section applies _ �
<br /> � The replacement of a Residential fixture or appliance that meets all three of the following requirements:
<br /> `. ' 1. ` Does not require modification to electrical or gas service.
<br /> ,r 2. Has a total cost of$500.00 or less;excludinQ tfie cost of the fixture or appliance: and Y
<br /> - � ;3.,_. Is unproved;installed or replaced by the homeowner or licensed contractor.
<br /> _ Skip next section,if this applies; ' Cost of Pemut , $ 15.00`
<br /> i: ; ::; � -
<br /> _,: � , • Sfate Surcharge '� $ .50(:
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<br /> .;. - , ; J ; Mail-In Fee(If Applicable) 1.50 ,�
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<br /> � . . , . :.n .. .. .
<br /> $
<br /> _ Total Permit Fee $
<br /> ,
<br /> ,:��� ��� _�PE�IVIIT FE���iI,CT�LA`�IONs(��-��JOBS;b�ER��S'0�;00��� .��z"±`���
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<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 /> � `j v G� x.0125 $
<br /> (contract price) : (minimum 535.00) �:`,. -
<br /> 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of�.50)
<br /> .,. . ;
<br /> ,_.. . '. , x.0005 $` = ..;~: ,
<br /> (contract price) (minimum$ .50)
<br /> - 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
<br /> . , .�;.
<br /> : 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
<br /> ` ` * CONTRACT PRICE or JOB COST means the actual or es6mated 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 funushed 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 pernut 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(9S2) 249-4600 for the price.
<br /> .,� �, ��, _
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<br /> -�.__ ,.. .. _.�. ,.. IvIEGHANLCA�-PERNtIT,APPLTCATTO�I4�,4�REEMEI�������.,:�'�,�; . �
<br /> The undersigned hereby applies to the City for issuance of a Mechanical Perniit, 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 statements made on this application are complete, true and .
<br /> correct. ;
<br /> Applicant's Signature: — C Date: � �' � � �
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