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11-29-'17 14:02 FROM- T-210 P0003/0007 F-605 <br /> tA , ^ <br /> '.P�RMIT;FEE;CAI;GUi>t�!TIQN{S)�.i�;` ,: . <br /> :,,- � �,;::`. <br /> `�3�� �E `:O�' 20 2� ,.T. ,S <br /> AS D.. �' 0,..�'A �. .'T�'�'C7���. <br /> [] 'Yes,this section applies <br /> The replacement of a Residential fixtttre or a,�pIiance that meets all three of the following rcquirements: <br /> 1. Does not r�quire modifcation to tlectricai ar gas servico. <br /> 2. Has a tota!cost of$500.00 or less;excludine the cost of the fixture or appliance:end <br /> 3. Is improved,instatlecl or rcplaced by the homeowner or licenscd contractor. <br /> Skip next section,if this applies; Cost of Permit S, ,15�,�„00 <br /> State Surcharge $ S_00 <br /> Mail-In Fco(If Applicablc) $ 2.00 <br /> Total Permit Fee $ <br /> >;PEI�iVIIT;FEE.G,AL;GULA'TIO�T(S)';-'JO;BS<bVER�$�00,�0� <br /> Tf abo�ve do�s not appl�;follovv guidelines below: <br /> l. CO1VT�iACT p�C� *is 1.25%of contraat price with a(Minimum�ee otS50.�� <br /> l/ �, �� � a ^����:, <br /> 2. STATESURCHARGE � �f <br /> �� � 6� <br /> 3, pOSTAO�&HANbT.TN'Cr(Only on Mail-In Applications) � �� <br /> 4. TOTAY.�'�,�tMC'K'���(Add Y.ines 1-3 Above) ���'.,e��������'���daJi�,� <br /> ■ & CONTRACT PRICE or JOB COST mcans tht actual or estimatcd dollar amount charged for tht <br /> permitted work including matcrials,labor,profit,and other fixed costs. It is the amount to bt ehBrgCd <br /> to tht customer for the work done. If any material,equipment, labor or instatlations are furnished by <br /> the owner,tenaht or any other peRy,the rrasonable market valuc of such 9tzms must be added to the <br /> estimated cost or conuact price for permrt fee purposes. Tn the event that there is a dispute on the <br /> amount o�'the job cost,the City may request the submission of a signed copy of the actual con�act. <br /> :.:..., ..,;. . _ <br /> ` " � � ME.CHt1I�TICPiL;PERMI3':AP,�LICATIQN;A(3REEMENT;���:�;�`�r <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit,agrees to do all <br /> wor—in�irs ie a�cco danee wifih�he ordinances of3he Ci and�he��ions of"�he S e of '�- <br /> Minnesota, and certifies that all Statements de o appiication are cornplete, true and <br /> correct. <br /> Applicant's Signature: , ��', r�' <br /> 3 <br />