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._ � <br /> � ' `-P�RIVIIT.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 three of the following requuements: <br /> 1. Does not require modification to electrical or gas seivice. <br /> 2. Has a total cost of$500.00 or less;excludine 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 Surcllarge $ .50 <br /> Mail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee $ <br /> PERMIT FEE CALCULATION(S)—JOBS OUER$500.00 '. <br /> If above does not apply; follow guidelines below: <br /> 1. CONTRACT PRICE * is 1.25%of conhact price with a(Minimum Fee of$35.00) <br /> ZS� 6 x.0125$ <br /> (contract price) (minimum$35.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of 5.50) <br /> x.0005 $ <br /> (contractprice) (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Oi�ly ou 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 /> pernutted 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 putposes. In the event that there is a dispute on the <br /> amount of the job cost, the City inay request the submission of a signed copy of the actual contract. <br /> ■ **'The STATE SURCHARGE is .0005 of the Building Deparnnent at(952)249-4600 for the price. <br /> MECHAIVICAL PERMIT APPLICATION`AGREEMENT <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, true and <br /> conect. <br /> �"' / Z -( -D S- <br /> Applicant's Signature: ������,�1 Date: <br /> 3 <br />