2012-01268 (mechanical) - Laserfiche WebLink

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PERMIT FEE CALCULATION(S) BASED OFF- 2002 STATE STATUE ❑ Yes,this section applies The replacement of a Residential fixture or a�pliance that meets all three of the following requirements: 1. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less;excludin�;the cost of the fixture or appliance:and 3. Is improved, installed or replaced by the homeowner or licensed contractor. Skip next section,if this applies; Cost of Pennit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ PERMIT FEE CALCULATION S -JOBS OVER $500.00 lf above does not apply; follow�guidelines below: 1. COIYTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of�50.00) f'Lj3��.��c X .o12s� �3,�� (contract pnce) (minimum$50.00) 2. STATE SURCHARGE �'�3��,cy� �.000s $ 2,6 5� (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 �, � � _ c 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ `� �.7 � ��'' — 7' �� ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including materials, labor,profit,and other fixed costs. It is the amount to be charged to the customer for the work done. If any material,equipment, labor or installations are furnished by the owner, tenant or any other part_y, the reasonable market value of such items must be added to the estimated cost or contract price for pennit fee purp�ses. In the event that there is a dispute on the amount of the job cost, the City may request the submission of a signed copy of the actual contract. MECHAIVICAL PERMIT APPLICATION AGREEMENT The undersigned hereby applies to the City for issuance of a Mechanical Pennit, agrees to do all work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements made on this application are complete, true and correct. Applicaiit's Signature: �Cti�- � Date: �Z�2'��""I Z Reset Form 3