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, , �. <br /> �� � � � � � PERMIT FEE C�LC'I�LATI�N(S} `� �� <br /> � BASED OFF -.20�? STATE STATUE <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance 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;excludin�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 /> �� �ay�� e� �� <br /> � �.��;����'� PERI�iT'�''�`� ��N S —J' ���.�.���: '�, <br /> If above does not apply; follow guidelines below: <br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> �—-, <br /> ��r � i ��� x .0125$ J��r�� <br /> (wntract price) (minimum$50.00) <br /> 2. STATE SURCHARGE � � �� <br /> ��UC,� < <,�� X.000s � <br /> �(oontract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> � <br /> 4. TOTAL PERM[T FEE(Add Lines 1-3 Above) $ ���r ��� <br /> ■ * CONTR.ACT PRICE or JOB COST means the arhial or estimate� 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 wark done. If any material, equipment, labar or installations are furnished 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 /> � �:.. ., � �. <br /> 0 <br /> � - �. TIQN A . ;,. EMENT ' ° ":. ... � . . <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 /> �� <br /> Applicant's Signature: � Date: �� �� � <br /> ; <br /> Reset Form <br /> 3 <br />