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01-30-'18 11 :32 FROM- T-474 P0003/0004 F-906 <br /> PB�tMIT�EE.CALCUL?iTION(S) . <br /> ..... ...... .. . ...... ..._....,: . . <br /> . .. Bf1SED�OFF=2002 STAT�STATUE ._ ..... .....................,...... .. .. <br /> ❑ 'Yes,d�is section applirs <br /> The replacement of a Residential fixturC or appli�nce that mcets all three of the following requirCmetlts: <br /> l. Does not rtquirc modification to elcctrical or gas servicc. <br /> 2. �Tas a totAl eost of$500_00 or Iess;e�cludine tha cost of the fixture or appliance:and <br /> 3. Ts improved,installed or rcplaced by the homeowner or licensed contractor. <br /> Ski�next seCtion,if this spplies; Cost of Permit $ 15.00 <br /> Statc Surcharge $ 5.00 <br /> Ivfail-[n Fee(If Applicable) $ 2.00 <br /> Tot�l Permit Fee $ <br /> . . . . .. .. ., .. <br /> PERMIT FE�CALC�,A'Z'ZON(S)-J�BS.OVER$500.00 <br /> Yf Above does not apply;foliow guidclines below: <br /> 1. CO1V�f RA,Cf pRYCE �`is 1.25%of concract peice with a(rlinimum�'ee of�,50.00 <br /> ' � �-A-r:/rt��..r�(��,:;h�={�/' � � '+�'l^:.�.; :,,;��., <br /> �fZ��fl�.iDn%:{'kC.0 iµ5 �iM1NF'.� .A�iry..:.1�::�(. <br /> RO <br /> 2. STATE SURCHACt�� C�ry�` � - �� <br /> :����5�..� <br /> 3. I�OSTAQE&�TANDLING(Only on�1ail-Tn Applications) $� � � �°`,��.rsi�:�. <br /> , � f <br /> 4. TO'CAL,P�Yti�1l'f���,(Add Lines i-3 Abovt) �;s�'<�' �i�l�:�`4%���'�:; <br /> ■ � CON7LZ�,CT PRICE or ]OB COST mEans the actual or estimated dollar amounc charged for the <br /> permitted�vork including materials,labor,profit,ftnd other fixed costs. It is the amount to be charged <br /> to the custoraer for the r.vork done. If xny material,equipment, labor or installations are fi�rnished by <br /> the owner, tenant or any other party, thc reasonable market value of SUCh items must be added to the <br /> es�imated cost or� contract price for permit fee purposes. In the event t�►at there is a dispute on the <br /> amount of the job cost, the City may request tht submission of a signed copy of the acri�al contraci. <br /> MECHANICAL 1°E1�M�T.APP�,YCATION AGREEMENT : . <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> �vork in sti•ict accordance 4vith the ordinances of the City and the regulations of the State of <br /> Minnesota, and cei�tifies that all statements made on t ' application are comptete, tr�1e and <br /> correct. <br /> A licflnt' i n � jr.. O� �7 <br /> pp s S g ature: '�f.e: ! � � U <br /> 3 <br />