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01-16-'18 12:30 FROM- T-416 P0009/0010 F-838 <br /> . � - <br /> ��R�XT.FEE CALCULATION(S). . . . <br /> . , BAS�7 O�-.200,2 STATE STAT'UE . <br /> ❑ Yes,this section applies <br /> The replacement of a Rtsidential fiXture or appliance that meets all three of thc following rcquircmcnts: <br /> l. boes not reyuire modification to electrical or gas se�wicc. <br /> 2. Has a total cost of$500.00 or less;axcludinQ the cost of the fixture or appliance:and <br /> 3. Ts improved,installed or replaced by the homeown�r or licensrsd contractor. <br /> Skip next section,if this applies; Cost of Permit S,15•00 <br /> State Surcharga $ 5.00 <br /> Mail-In Fec(If Applicablt) $ 2.00 <br /> Total Permit Fee $ <br /> PERIVIIT FEE CAI;CUL;AT'�ON(S)=JOBS pVER$500:00 <br /> Jf above does not apply;follow guidelines balow: <br /> l. COiY'X'�tA,Cx P�tXC� *is l.25%of contra�.�-J with a{Mlnimum�ea of�50.40) <br /> I�7 ��.,. �:���D.��,� <br /> ----� � � �� .�� <br /> 2. STATE SURCFIARGE 2� �? <br /> J ;��OQO�;, Q <br /> 3. �OSTA(��Bc HANllLING(Onty on Mail-Tn Applications) $�� ��;riae':���` <br /> � � <br /> 4. TQTA�P�CtMIT F��(Add Lines 1-3 Above) ��sS;s��+,g��::�t`�.,`: <br /> ■ '� CONTRACT PRICE or JOB COST means thc actual or estim2ttd dollsr amount charged for tho <br /> pqtnitttd work including mattrials,labor,profit,and other fixed costs. It is thc amount to bc chargcd <br /> to the customer for the work done. If any material,eqttipment, labor or installations are furnished by <br /> the ownzr,tanant or any other party,the reasonab[e markzt valuz of such items must be�dded to the <br /> estimated cost or contract price for permit fee purposes. In the evznt that there is a dispute on the <br /> amount of the job cost,the Ciry may requast the submission of a signed copy of the actual contract. <br /> MECHAIVICAL PERMIT APPLICATION AGREEMENT.: . , .,.: :.`: : <br /> The undersigned hereby appiies 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 cerlifies that atl statements made on this application are complete, irue and <br /> correct. <br /> Applicant's Signatiu�e: r� �:,� 1�'I 11/�` O <br /> 3 <br />