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11-29-'17 15:21 FROM- T-216 P0003/0004 F-611 <br /> PtRMIT FEE CAI,CULATION(S) <br /> ,BASED QPP:'2O02,STATE STATO <br /> 0 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;excluding 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 Fcc(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> PERMIT S'EE'CALCULATION(S)H.TOBS.OVER'$500:00. <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE §is 1,25%of contract n,tract price with a(Minimum Fee off$$50.00) 7J <br /> :d. <br /> 2. STATE SURCHARGE /( r5- 4:6014) 3 ©`1' <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) ($ <br /> 4. TOTAL PERMIT FEE(Add Lines 1.3 Above) x:g.fklY)144,,,. „ <br /> • * CONTRACT PRICE or JOE 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 /> MECHANXCAL PERMIT:APPLICATIONAGR.EEMENT . <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> work—in stiiR 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 /> Applicant's Signature: arAlAildik/ xa.., <br /> 1 ,1'47 <br /> 3 <br />