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9529331869 14 34 00 06-03-2015 4/4 <br /> PERMIT FEB CALCUL.4TION(S) <br /> BASED OFF -2002 STATE STATUE <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> l. Does not require modification to electrical or oas service. <br /> 2. Has a total cost of$500.00 or less;excludinQ the cost of the fixture or appiiance:and <br /> 3. Is improved,installed or reptaced by ihe homeowner or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ I S.OQ <br /> State Surcl�arge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> 'Cotal Pern2it Fee � <br /> PERMIT�EE CALCULATION(S)-JOBS OVER$500.00' <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> �' �00•00 x.o�2s$ 50.d0 <br /> (wntract�ricc) (minimum 550.00) <br /> 2. STATE SURCHARG� <br /> � 500.00 X.000s � 4.2�", <br /> (conlroCl pricc) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT'FEE(Add Lines I-3 Above) $ �J' �.2r'J <br /> ' *' CONTRACT PRICE or JOB 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 fumished by <br /> the owner, tenant or any otfier party,the reasonable market value of such items must be added to thc <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 Gity may request the submission of a signed copy of the actua! contract. <br /> MECHANICAL PERMIT APPLICATION AGREEMENT <br /> The wldersigned hereby applies to the City for issuance of a Mechanical Perznit, agrees to do all <br /> work in strict accordance witli 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 /> Applicant's Signatur • �� Date: O� 4� 1-�-.� <br /> � <br /> 3 <br />