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, �, <br /> t � <br /> -- PEIZMTT'�EE CALCULATION(S) <br /> __ .Bt�SED O#�F-2002 �TATE �TATI7E <br /> ❑ Yes,this sec4on applies <br /> Thc replacemenY of a Residential fixture or appliance that meets all three of the following reqniremertts: <br /> 1. Does not require modification to elecirical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludin�the cosi of Tlie fi�ctute or appliaace:and <br /> 3. ls 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 $ 1.00 <br /> Mail-In�'ee(IfApplicable) $ 2.00 <br /> Total Permit Fee S <br /> ( �PERMIT FEE CALC�LJLATIUN{S}-TpBS�'jVER$500.00 <br /> If above does not apply;foliow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> �=��7.r~i� X.o E 2s$ _ <br /> (contract price) (minimum 550.00) <br /> 2. STATE 5URC�IARGE <br /> x.0005 $ <br /> (cootract price) <br /> 3. POSTAGE&HANDLING(Ority on Mail-ln Apptications) $ 2.00 <br /> 4. TOTAL['ERMIT FEE(Add Lines 1-3 Above) $ ��,�� <br /> � * CON7'RACT PRTCE or JOB COS�'means the actual or estimated doltar arr�ount charged for the <br /> perniitted work including materials, labor,profit,and other fixed costs. It is thc amonnt 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 vafue of such items must be added to the <br /> estimated cost or contrae;t price for pernut fee purposes. ln the event that there is a dispute on the <br /> amou�t of the job cost, Yhe City �nay request the submission of a signed copy of the aetual contract. <br /> . MEGI�ANIGAL P�R1�IT A�'PLTCATION AGREEMENT <br /> The undersigned hereby applies to the City for issuance of a Mechariical Perm'tt, agrees to do all <br /> work in strict accordance with the ordinartces of the City and ihe regulations af the State of <br /> Minnesota, and certifies that ail statements made on this application are complete, true and <br /> correct. <br /> Applicant's 5ignature: �J ��� Date:_l����� <br /> 3 <br />