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� <br /> � PERMIT FEE CALCULATION(S) � � <br /> BASED OFF - 2Q02 ST�TE STATUE " <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 /> 2. Has a total cost of$500.00 or less;excluding 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 /> s,;�* �,s f <br /> �'ERM1T�' . Y � �.. 'T� . . � �-7Ct�.3S Q�;�:.�. _.�,,.,�,� �.,.: ...�. <br /> If above does not apply,follow guidelines below: <br /> ]. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00) <br /> ����l�l� �«l� X.oizs $ 1 I�,c1=� _ <br /> (contract price) (minimum$35.00) � <br /> r <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge( inimum Fce of$.50) <br /> �"{����ti .0005 $ � � <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> 4. TOTAL PERMIT 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 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 SliRCHARGE is.0005 of the Building Department at(952)249-4600 for thz price. <br /> �_ , 7� �. , .. <br /> �" '` � �r .. , �Cf�L�T�' �� r' r� .� hi- <br /> �; < <br /> � <br /> � <br /> , <br /> �.�y ... . .,�.•::� � •... � '� <br /> ,,.. .�rv i'�'i:n Ak..i�.:.� x':;•.� <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 statements made on this application are complete, truc and <br /> correct. <br /> �, ,�/�, <br /> Applicant's Signatur � ��c.V '�""`'"�'" Date: � �� �� <br /> Reset Form <br /> 3 <br />