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t �+ <br /> , <br /> � <br /> �E�iMIT F`EE CALCULATIQN{S) <br /> BASED OFF-2002 STATE 5TATUE <br /> ❑ Yes, this section applies <br /> The replacement of a Residential fixture or a�Qliance that meets all three of the following requirements: <br /> �l. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludine the cost of[he fixture or appliance: and <br /> 3. [s improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ 1 i.QO <br /> State Surcharge � $.pp <br /> Mail-�n Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> P��I'�����ALCU`�1�'�C7N � -1fl8�C��J�R$540.U0 <br /> If abovc does not apply; Follow guidelines below: <br /> 1. CONTRACT PRICE * is 1.25°r'�,of contract pricc with a(Minimwn Fee of$50.00) <br /> �Dl�� a .0�25 � I oo.r� <br /> (rontruct price) Imini�num$�0.011) <br /> ?. STA1'E SURCHARGE <br /> �60�� � .000s � �.b� <br /> (contr:ict price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. T01'AL PERMIT FEE(Add Lines 1-3 Above) $ ��b•� <br /> ■ �'� CONTRACI' PRICE or JOB COST means the actual or eslimated dollar amount charged for the <br /> permitted work including materials, labor, profit, and othcr fixed costs. lt is the amount to be charged <br /> to the customer for Che work do�ie. If any material, equipmenl, labor or installations are furnished by <br /> thc owner, tcnant or �ny uthcr party, the reasonable market valuc of such items i»ust be added to lhe <br /> estimatcd cosl or contract price for permit fce purpvses. In the evcnt that there is a disputc on tlie <br /> amounl of thc job cosl, the City may reyucst the submission of a signcd copy of the actual contract. <br /> MECHANiCAL PERMIT AP�'LICATI�N AGREEIvIEN1' <br /> The undersigned herehy applies to the City for issuance of a Mechanical Permit, agrees to du all <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesola, and certiiies lhat all statements made on this application are coinplete, true and <br /> correct. <br /> Applicant's Sigilature: Y�..V� Date: � �S `� <br /> Reset Form <br /> 3 <br />