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� , <br /> . <br /> • ` <br /> PERMIT FEE CALCULATION{S) <br /> BASED OFF-2�0� S'I'ATE STATUE <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or a�pliance 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;excludin¢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 Surchazge $ 1.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> PEl�I�1i'T F�E CAI;CULATION S -��� C?�ER$St��.O�l <br /> If above does not apply; follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of coniract price with a(Minimum Fee of$50.00) <br /> � . <br /> ,� �,<-�:J �',� X.O 12S$ <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> c <br /> / G '! � , �� X.00OS $ <br /> (conuact price) <br /> 3. POSTAGE&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 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, labor 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 /> I�E��[ANiCAL P����'�?�'LI�A1'��'..AG�E�ENT <br /> The undersigned hereby applies 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 certifies that all statements made on this application are complete, true and <br /> conect. <br /> Applicant's Signa re: � ��c.�-�/�L�.����s� Date:/ �- -' �� — /`� <br /> � ��- <br /> � ���z � � y <br /> 3 <br />