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. <br /> i " <br /> PERMIT FEE CALCULATION(S) <br /> BASED OFP- 200� STATE STATUE <br /> � Yes,this secrion applies <br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> 1. Does not require moditication to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludin�the cost of the fixture or appliance: and <br /> 3. Is improved,installed vr replaced by the homeowner or licensed contractor. <br /> Skip next secrion,if this applies; Cost of Pertnit $ 15.00 <br /> 1�1� q$ �`t 11�. � State Surcharge $�.89� , � 00 <br /> �� t`�`�f��'" ��5�� J ����. Mail-InFee(If Applicable) $ 2.00 <br /> S ir��� �r,e p l O�C._,�!'\� � ,,- , ��C �►� ; t Totat Permit Fee $ -- _ _. <br /> , _.. . -.. . . . • <br /> � ; . . , . .- . <br /> � , ,, , , a , ; A :� <br /> f�Gy - ...,._ . , , • :. . .: ..r '_�-."- <br /> PERMIT FEE CALCULATION(S}-JOBS OVER$500 QO <br /> [f above does not apply;follow guidelines below: <br /> 1. CONTRACT PitICE *is 1.25%of contract price with a(Minimum Fee of$SO.OU) <br /> x.0125$ <br /> (contiact price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> x .0005 $ <br /> (conh�act piice) <br /> 3. POSTAGE g HANDLING(Only on Mail-In Applications) $ 2.00 <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 iiicluding materials, labor,profit, and otlier 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 fumished 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 /> MECHANICAL PERMIT APPLICATION AGREEMENT <br /> The undersigned hereby applies to the Ciry 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 inade on this application are complete, true and <br /> correct. <br /> Applicant's Signature: � �^ ��--, /� � .-�---�— Date: 8 / �� / i s <br /> 3 <br />