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� PERMI�I� FEE CALCULATIC?N(�} � � � <br /> � BASED �FF - 2fl{}Z��STATF STATUE <br /> ❑ 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;excludin�the cost of the fixture or appliance: and <br /> 3. Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip ne�.t section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> T'otal Permit Fee $ <br /> , <br /> � ? 1�� ,.'.. ,.. ,.; ��. '... �. � #�BS OVER`�t�4.00 <br /> a � � <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 /> ��:��X,� � ��i"7 <br /> , X.o�2s $ � J � <br /> � <br /> (contract price) (minimum 550.00) <br /> 2. STATE SURCHARGE �X' �� <br /> ����x.0005 $�_ " <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> ����u <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ l <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted wark 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 /> amo�:nt �f t!ze job cost, the Ciry may request the subrnission o�a signed copy of tiie actuai contract. <br /> s.. . , „ r, <br /> � <br /> . <br /> � � � ` ff�E�:� _� `�;, � <br /> , �, <br /> � s �;: <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> work in strict 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 /> , <br /> '° '� ' �j ' <br /> PP ' g � ° � ' �� <br /> A licant s Si nature: Date: <br /> 3 <br />