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P���Iz���E eaLCUL ���TION�s� � <br /> sasE� c��F -2oa� sT�T sTAT� � <br /> ❑ Ycs,this section applies <br /> I he replacement of a Residential fixture or appliance that meet all three of the followin�requirements: <br /> 1. Does not require modification to electrical or gas rvice. <br /> 2. Has a total cost of$500.00 or less;excluding the c st of the fixture or appliance: and <br /> 3. Is improved,installed or replaced by the homeo�r er or licensed contractor. <br /> Skip neht section,if this applies; Cost of P rmit $ 15.00 <br /> State Sur harge $ 5.00 <br /> Mail-In F e(If Applicable} $ 2.00 <br /> Total Pe it Fee � <br /> , �?` '��;��., ��:��,�.-'��'�'��'' — E}BS�:� ...� , :.: '' ,,,, f ,. <br /> s . <br /> If above does not apply;follow guidelines below: <br /> 1. COI�TTRACT PRICE * is 1.25%of contract pri with a(Minimum Fee of�50.00) <br /> "T•�0�, � x .0125$ �C;�,Z� <br /> (contractprice) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> ��OD, DD x.000s $ `�'' �2' , <br /> (contrac[price) <br /> 3. POSTAUE&HANDLING(Only on Mail-In Appl cations) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) �� � � � <br /> ■ * CONTRACT PRICE or JOB COST means the actual r estimated dollar amount charged for the <br /> perniitted work including materials, labor,profit,and othe fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material, equip ient, labor or installations are furnished by <br /> the o«ner,tenant or any other party,the reasonable mark t value of such items must be added to the <br /> estimated cost or contract price for pennit fee purposes. In the event that there is a dispute on the <br /> amount of the job cost, the City may request the submis on of a signed copy of the actual contract. <br /> ���,`�� '' ��:��.-�'� ��, ���� � �?, <br /> �� F <br /> The undersigned hereby applies to the City for issuancc f a Mechanical Permit, agrees to do all <br /> work in strict accordance �vith the ordinances of the ity and the regulations of the State of <br /> Minnesota, and certifies that all statements niade on is application are complete, true and <br /> correct. <br /> , <br /> Applicant's Signature: �W�'��'�" Date: ^ GLJ� � � <br /> Reset Farm <br /> 3 <br />