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�-- � PI�RIViI't'F�E�CALCUL�I�I'ION(S) � <br /> �-.-------� --B�SE?I� O�I'_2002 S"I�AT E; S7�A'TUE � <br /> �� Yes, this sectioi�applies <br /> �I�he re��[acement of a Residential fxture�or��pliance that meets;�ll three ofthe Collo��ving requirements: <br /> I. Does not require modificotion to elecCrical or gas serv�ce. <br /> 2. 1 las.i total cost of�500.00�,r Iess; excludin�*the a�si of ifie tixtiu•e or a��pliance: and <br /> 3. Is improved, installed or replaced by the home<�wner��,r licenscd eontractor. <br /> SkipnexTsection, ifihisap��lies; ('ostofPcrmil <br /> �__��.00 <br /> St�ate Stu�char�rc $ .50 � <br /> t��lail-Inl�ee("If�pplicable) $--L50 <br /> �Tot.il Pcrmit I�ec � -- <br /> ----- <br /> � -- _ --_PERMIT FEE_C�1L,C'ULATION(S__ IO[3� OVrR $5DOA0 <br /> -_. <br /> __--_ ___- <br /> If above�does not apply; follo�v guidelines below: � <br /> 1. CONTRA('T PRICE * is I."?>°%of conYl•�cL price with e(Mi11iI1111m Fee Of$35.00}� <br /> -�--5-��-a�T�: � �>>�, � � � �.� <br /> caihtrict�,ncn) ---- ----�------ <br /> (minimum�43i UC) <br /> ?. 5T,4T�SURCHAR('E "'� Add the State Bldg(`cxie�I)iv. Surcharge(Minimu,n Fe of'x.50) <br /> _�, � �, <br /> l��. �_�.��j x .00O S � '� � �7"� <br /> (cuhti:ictpricc) �—� --�tnmimum'l' >Uj -- - <br /> �. POST'AGE�ec 13nNDt,INC�(pi�fy �,i� �qail-In A��plic�iti�ns) 4, --- I.50 <br /> �� <br /> �t. TOTAI_,PERMIT FE[:('�1dd Lines (-:, Ab�ve) �./ <br /> �'-- --�------- <br /> �" �'� C'O�ITR/1C'F PRI<'E or JOF3 ('nS7' �tielns d�e .iclu�l or estimated �lollar amoi�nt char�ed �for the <br /> permitted ��vork incfudin� materials, labor, profif, and otl�er fixed costs. ft is tl�e amount to be charged <br /> 1� the customer for the�w�irl< done. ff.iny material, equipment, lab�ir or installations are fin�nished by <br /> the otvner, tenant or any other ��arCy, the re�asonable marl;et value of such itei��s must be adcied to [he; <br /> estint�ted cost or conh�act price for ��ern�it fee purposes. In Ihe event that there is a dispute on t:he <br /> <im��unt of the job cost, the City tiiay request the submission of� signed copy of the actual contract. <br /> ' �`�` The STA'�[?SL'RCI-lA RCL is .(1�05 �f the E3uilding(�epartment at(9�2)249_4G00 foc the price. <br /> — — — ------ <br /> ___ ______ __MEC_HANICAL PE_R_MiT APPLICf1Tl(:)N AG_REBME�IT__i � <br /> ['he i�nde�:signed hereby applies to thc; Ciiv for issuanc� of�a Mechanical Yermit, agrEes to do all <br /> iv�+rl: in strict accordanc� �,viih Yl�e ��rdinances �f the City ttncl ihe re�ulations o�f the State of <br /> vlinnesota, and certifies thaY al( SPatements inade �n this ,�E�pfication are complef.e, true and <br /> c��rrecl. <br /> - <br /> -� <br /> ���plic�nt's Si�nature: � �jJ <br /> "`'-_`-�- _ � ---�--���� _ f�afe: �j � � ��__— <br /> Sf t f uc�sn <br /> , <br />