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. 09-07—'17 09:45 FROM— T-756 P0003/0004 F-106 <br /> � . .. �.. PERMIT.FEE CALGUr,ATION(S) : .: ..:� � : ,. . <br /> BASED OFF=.ZU02 STATE STATUE. .��. �:� :` . . .: � <br /> Q 'Yes,this section applits <br /> The replacemcnt of a Residential fixture or appliance that meets all three of the following requirements: <br /> l. boes not t'equ�'e modification to eiectrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludin thc cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaecd by the homeo�wner or licensed contractor_ <br /> Skip next scction,if this appiies; Cost of l�erm'rt $ 15.00 <br /> State Surcharge $ 5.00 <br /> MaiI-In Fee(If Applicable) $ 2.00 <br /> 'X'otal�ermit Fee S <br /> :, P��MT�F�CAL�C]ri.;ATYON(S)'�JOBS�OVER$500.00 .,` .�.;.: <br /> Tf above does not apply;fpllow guidclines bclow: <br /> 1. CONTRACT PRICE '"is 1.25%o contract pricz�+vith a(1V�inimum Fee of$50.00) <br /> �� /�` ""��."..,,,-'-,- -�:��,� <br /> 'rH 1��..�`':;4';'•.`,i''T.�i�!�3.�;�"v.':i:s��"�"�"1;:�;.-.� <br /> ��'t01.'t�I�t�k � `p1j11��1�!.�.'L•...�V <br /> 2_ STATE SCJRC�TARCx� 5 ��(� j �( <br /> �.' .'� <br /> x�OQ05.�'._$� l - <br /> 3. POS7'AGE&HANDLING(Only on M&il-1n Applications) O__.� �'�� <br /> i•?..�,:., <br /> 4. TOTAL PERMIT�'E�(Add L'rnes 1-3 Above) ��-Tr�:.�'� ' �`:'�`�� <br /> ■ * CON'TRACT p�iTCB or 70B COST means the actual or estimated dollar arnount charged for the <br /> permitted work includin�materials,labor,profit,and other fisced casts. Tt is the amount to be charged <br /> to tfte customzr for the work donc. If aE�y matcrial,equipment,labor or installat�ons are furnished by <br /> the owner.tenant or any other parCy,tht reasonable marl�et'value of such items must be addcd to the <br /> estimated cost or contraet price for permit fee purposes. Yn the event that there is a disputo on Che <br /> amount of tho job east,the Ciry may request the submission of a signed copy of thc aetuai eontraet. <br /> MEGHAIVICAL PERMIT APPLICATION.A:CxR,E�1VIENT , <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit,agrees to do ail <br /> work in strict accordance with the ordinances of t City and the regulations of the State of <br /> Minnesota, and certifies that all statements ma on this application are complete, true and <br /> correct. <br /> Applicant's Signature: �te:: ��_� I <br /> 3 <br />