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9529331869 15:25:09 10-07-2015 4!4 <br /> �I�' # <br /> PERMIT FEE CALGULATION(S) <br /> I <br /> BASED OFF-2002 STATE STATUE <br /> � <br /> I ❑ Yes,this section applies <br /> The repiacement of a Residential fixture or appliance that meets all three of the following rec�i�irements: <br /> l. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excIuding the cost of the fixture or appliance: and <br /> 3. Is improved,installed or replaced by the homeowner or ticensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 1 AO <br /> Mail-In Fee(Tf Applicable) $ 2.00 <br /> I�i Total Permit Fee $ <br /> I PERMIT FEE CALCULATTON S)-:JUBS OVER$500:00 <br /> � <br /> If above does not apply;follow guidelines below: <br /> I. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> -� �ccr .c:� X.0�25$ � ��:� . t� <br /> (coi»ract pricc) (minimum$50.00) <br /> 2. STATE SURCHARGE ,� (C� �j <br /> x.OQOS � , � <br /> (contract pricc) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) � .� <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ��} �`�� <br /> ■ * CONTRACT PRICE or ]OB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor,proft,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 o�vner, 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 dispuke on the <br /> amount of the job cost, the City may request the submission of a si�ned copy of the actual contract. <br /> ' NIECHANICAL;PER1vIIT APPLICATION AGREEMENT <br /> � <br /> _ _ <br /> The undersigned hereby applics to the City for issuance of a Mechanical Pern�it, agrees to do all <br /> work in strict accordance with the ordinances of the City and the regulations of the Statc of <br /> Minnesota, and certifes that all statements made on this application are complete, true and <br /> correct. � <br /> / . � <br /> C_./ �' ���I�,/t <br /> A plicant's Signat re: '�G/YL(.�. �� L��'-�..x-t%���. Date: ��/� �� <br /> P <br /> / , <br /> ;I 3 <br /> _ �, _ <br />