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c � <br /> ---- -- — ------- <br /> PERMIT FEE E'�I.C"UL:�TION(S} <br /> F�ASED OFE' - 2�O? STATE: STATUE <br /> ❑ Yes, this section applies <br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less; excludinQ the cost of the fixture or appliance: and <br /> 3. Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> �E��rT r�E c,�.�.cUL,��rr��v�s7-JOBs ci�fEr.���o.c�a � <br /> If above does not apply; follow guidelines below: <br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> � � ��dr �� X.�I25 � ����J' <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE � ��� ,�� x.0005 $ �-�� <br /> ( ntract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> n � <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ��n �� <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor, profit, and other fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material, equipment, labar or installations are furnished 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 /> �"'� , �"1 �'+ 7�,{ �7 ,� <br /> ::�� � ;,�� � hn.;;�;' - '� , , '.�✓��� �,���.: , �� „ .�.,i . ���1�4��:1:E1VtEtVT ���-;�?:: <br /> The undersigned hereby applies to the City far 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 made on this application are complete, true and <br /> correct. � � <br /> ,� <br /> ' %' ,� '. <br /> , r�.._.-_;:-_________.__ �Gj/��11� <br /> Applicant's Signature: ���� �-� Date: � <br /> �� <br /> � <br /> 3 <br /> � <br />