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PER�vII"1, 1��EI� CAI,CULATION(S) <br /> �3ASED OF1� - �002 STA1'I�� S"[,A"I�UE <br /> ❑ Yes,this section a�plies <br /> The replacement of a Residential fixture or appliance that meets all tl�ree of the following requirements: <br /> l. Does not require modification to electrical or�as 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 homeo�vner or licensed contractor. <br /> Ski� next section, if this applies; Cost of Permit $ I5.00 <br /> State Surchar�e $ 5.00 <br /> Mail-[n Fee(If Applicable) $ 2.00 <br /> Total Permit Fce � <br /> � PERMiT F�E CAi,CiJi,A�i�Ii7N�S) —JOBS �VEic $�OO.GO � I - <br /> If above does not appl��; follo�v �uidelines below: <br /> L CONTRACT PRfCE * is 1.25%of contract price with a(Minimum Fee of��0.00) <br /> a�Qb x .0125 $ ,�'���0 <br /> (cuntrict price) (miuimum Si0.011) <br /> 2. STAT[: SURCHARGE <br /> x .0005 $ �• � U <br /> (contract price) <br /> 3. POS"I'nGE�. HANDLING (Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PGRMIT FEE(Add Lines 1-3 Above) $ � � � � � <br /> • * CONTRACT PRICG or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted worl: includin�r materials, labor, profiC, and other fixed costs. It is the amount to be charged <br /> to tlle customer for the work done. [f any material, equipment, labor or installatioils are fw-nished by <br /> the o�vner, tenant or any other party, the reasonable macket value of such items must be added to the <br /> estimated cost or contract price for peru�it 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 si��ned copy of the actual contract. <br /> MECHANICAL PERMIT �PPLICATION AGREEMENT <br /> The undersigned hereby lpplies to the City for issuance of a Mechanical Permit, agrees to do all <br /> work in strict accordance with the ocdinances of the City and the regulations of the Statc of <br /> Minnesota, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> . ,. <br /> Applicant's Signat�u�e: — ' Date: / / � � <br /> Reset Form � <br /> -, <br /> J <br /> I, <br />