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Apr 29,14 03:30p Huber 763-231-0295 p.5 <br /> PER�'�IIT �'EE CALCULATI0�1(S) <br /> BASED OFF -2002 STATE STATUE <br /> ❑ Yes,this section appfies <br /> 'f'the replacement of a Residentiai fixture or a iiance that meets all three of the following requirements: <br /> 7. Does not require modification to electrical or gas service. <br /> 2. f Ias a total cost of$500.00 or less;excl�dine the cost of the fixtwe or appliance: and <br /> 3. [s improved, instal]ed or replaced by che homeowner or licensed contracior. <br /> 5kip ne�ct section,it'this applies; Cos[of Pennit � �s.00 <br /> Stace Surcharge $ 5.00 <br /> Mai!-In Fee(If Applicable) $ 2.00 <br /> Tota!Permit Fee � <br /> PERMIT FEE CALCliLATION S —JOBS ��`ER$500,00 <br /> lf above does not apply;follow guide[ines below: <br /> 1. CONTRACT PRICE *is i 25%of contract price w�ith a(Minimum Fee of�50.00) <br /> 6��.4 RR Y .o i zs� 80.63 <br /> (contract�ncc) (minimum 550.60) <br /> 2. STATE SURCfIA�2GE <br /> 6450.00 X.000s � 323 <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) � 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) 5 $�6�6 <br /> ■ * CO�lTRACT FRICE or JOB COST means the actual or esumated dollar amount charged for the <br /> permitted work including�naterials, labor, profit, and other fixed costs. Lt is the amount to be char�;ed <br /> to the customer for the�vork done. lf any material, equipment, lab�r or installations are fi�rnished by <br /> the owner.tena�t or any ocher party, El�e reasonabte mar3cet�alue af such items must be added to the <br /> estimated cost or contract pricc for permif fee purposes. In the event ihat there is a dispute on the <br /> amount of the job cast, the City may request the submission of a signed c�py of the actual contract. <br /> MECHAMCAL PERMIT APPLICATIO� AGREEME�iT <br /> The undersigned hereby applies to the City for issuance of a Mechanicat Permit,a�rrees ta do alI <br /> wdrk in strict accordance with the ordinances of the City and the regulations of tite State of <br /> Minnesata, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> � <br /> Applicant's Signature: _ __ '`� Date: 4/29114 <br /> i <br /> � <br /> � <br />