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10-15-'15 12:18 FROM- T-358 P0006/0007 F-679 <br /> , , 'PBRMIT�EE CAL�US�ATrON(S)' <br /> � B!�S�I?Q'��';-�2002 STA.TE STATiJ�. �•} <br /> ❑ Yes,this section appiics <br /> The replacement of a Residen i lj�}ce th�t meets all three of the folkowing requirements: <br /> i <br /> 1, Does nos require modification to electrical or gas se�vice. ; <br /> 2, �as a�j,�,st of$500.00 or less;excludin Che cost of thc fixture or appliance:and � <br /> i <br /> 3. Is improved,installed a�replaced by the homeowner or lieensed contractor. <br /> Skip next section,if thi�applies; CosC of Permit $ I5.00 <br /> State Surcharge � 5.�0 <br /> Mail-ln ree(yf Applica6lc} $�2.00 <br /> Totai permit�ee $ <br /> j <br /> ' P��2M7T����,���:4�C�U�:A I'T{7N�S)—;7U�3S Ct'V�R$�UO.QO .; ,�';;; ; <br /> ,..� _ ..�.� �..� ; <br /> IFabove does not apply;Pollow guidtlincs bclow: � <br /> 1. COIVTRACT�'�t�C� * is 1.25%of contract pr'rce with a(D�inimum Fee of$50.00} � <br /> _ 1��� x.a125$' .���, <br /> ;(cv�itrsFt p��ice) (minjmum 550,00} � <br /> � i <br /> 2. STAT�SCJT2CT�ARC� +� I �,� �V�_ � <br /> � x`.Q005 $ � <br /> �(Gontf�ot pr3Ga)� � <br /> 3. POSTAG�,&I-(ANDLING(Only on Mail-Cn Applications) $ 2.00 ; <br /> Z��'�- '� <br /> 4. TOTA�p��21Y11T���(Add Lincs 1-3 Abavc) $ ; <br /> � <br /> ■ R CONTRACT PR10E or J013 COST menns thc actual or estunated dollAr amount charged for [he I <br /> permitted work ietcluding mate�•ials, labor,profit,and other fixed costs. It is the amount to Ue charged <br /> to Yhe customer for the work done. If any mAtcrial, eguipment, labor�r installations arc furnished by <br /> the owner, cenant or any other parry, the reasonable markat value of such items must be added to ihe <br /> estimated cost or contract price for permit. fee purposes. rn the event that there is a dispute on the ; <br /> �mount of the job cost, the City may request the submissio�i of a signed copy of the actual contract. <br /> i <br /> � <br /> � <br /> '' '::IyI�CT-�AN]:CAL PE�yIYT AppLICATTON AGI2EETv$EN�':•;" � <br /> _..____._. � � <br /> � <br /> The undersigned hereby applies to the City for issuance of'a Mechanical Permit, agrees to do all i <br /> work in strict accordance �vith the ordinances of the City and the regulations of the State of � <br /> Minnesota, a��d certifies that aU statemcnts made on this applicat.ion are complete, irue �nd ; <br /> correct. 4 <br /> Applicant'sSignature: �-��"'''V ��vl'T'L''�'j'" T.7at:e:!_ 1 f� I <br /> � <br /> 3 <br /> � <br />