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R <br /> ` , t� <br /> ...a N � f tiw N*e�«,yr�. y, :; � . ., ■ <br /> ,�:��u,.��,,,��;.,�„.;rt�.„; ..n,'PERMLT�MFEE"�CALCLTI;ATION(S) �h , M w ' <br /> ""�'�� ' " �"�"� � "'.::'BASED OFF -2002 STATE STATUE �r� �=�i a�� .'� �'�..>r;; ";: <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 tota]cost of$500.00 or less;excludine the cost of the fixture or appliance: and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> ,,;,'��.,�,;�"���P„ERIVIIT�'F,EE;�CALCi7I;ATION S �;-�JOBS`OVER�$5QO�Q0 <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 125%of contract price with a(Minimum Fee of$50.00) <br /> ����C.� <br /> x.0125$ <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> x.0005 $ <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work 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 fumished 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 /> amount of the job cost, the City may request the submission of a signed copy of the actual contract. <br /> i"�"�� `��;1ViECHAI�IICAL;';PERIVIIT'APPL`ICATION°�AGREEME,.� . '� <br /> �� �� <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 /> '�� r <br /> Applicant's Signature: ����'�,�' `/ _JL L' �E Date: � U tQ � � <br /> 3 <br />