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, r , <br /> ��� � � '���'�� � PEIZMIT FEE C�4LCULA'TIOAT(S) <br /> I �BASED OFF-20�2 S'TATE STATLTE <br /> ❑ Yes,this section applies <br /> The repEacement of a Residential t�iKture or apnliance that mects all three of the fo�lowing requireinents: <br /> l. Does not reyuire inodification to electrical or gas service. <br /> 2. Has a total cost of�500.00 or less;excl�udina the oost of the fi;:ture or appl iance: 2nd <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor_ <br /> Skip nean sectio�n,ifthis applies; �I Cost of Permit $ 15.00 <br /> ' I State Surcharge � � pp <br /> ; I Mai]-In Fee(IfApplicable) $ 2 fl0 <br /> , ! Total Permit Fee $ <br /> ' � <br /> �_ PERMIT F�E CALCULATII�N{S)-JOBS OVER$500.00 <br /> If abuve does not aprly;follow'guidclines below: ', <br /> i <br /> I. C0IVTRAC'I'PRIC� * �s 1.2�%of comract price with a('.Ninimum Fee of$�OAQ) <br /> , /02� � X.a1�s� j—(� • UC7 <br /> �i (contract price) mininium$50.00) <br /> 2. STATE SURCHARGE j !]�, � /`�� /, <br /> � I � �? �� x.0005 � �f <br /> fcontract price) <br /> 3. POSTAGE&1��1�N�DLIN(i(Only on l�Iail-In Applications) $ 2.Op <br /> I� ' Q' d � <br /> 4. TOTAL PERti11T'�I+EE(Add Lines 1-;Abave R • <br /> ) .. �l) <br /> • '� CON"I"R,1CT PRICF, oi'IIJOB COST means the actual or esnmated doitar amou�t char�ed for the <br /> permitted work including�'materials,labor, profitl,and olher fixed cosls. ft is the amount to be char2ed <br /> to CF►e customer for the work done Tf any material,equipment labor or u�stallalions are furnished by <br /> the owner, tenant or an}�ot.�er party, the reasonable market value of such items must be added to t�e <br /> estimated cost or contrac� price for permit fee pur}xfses In the e��ent dlat there is a dispute on the <br /> amoiint of the job cost,ttie City may request the submission of a signed copy of the actua� contract. <br /> ' II <br /> [----' MECI-�AhII AL PERMIT I PLICATION AGREEMENT <br /> , �I <br /> The undersigned hereb a 'll�I'ics to the Ci for rssuance of a Mech�n'� o <br /> Y PP �S' a �cal Permrt, a�rees to �o a11 <br /> wo:k in stricl accordance with tl�e ordinances �Icrf the City and the regulations of the State of <br /> Minnesota, and certifies tii�a't all statements made on this application are compfete, true and <br /> correct 'i i I <br /> / �i �/ / <br /> Applicant's Signattue: ate: ! / <br /> Ili I <br /> � I <br /> 3 <br /> I' i , <br /> � d �},gZ-ggL-�gg oi;ona�suo��uo�sn�_ia}�e� d£Z Z091 lZ lnf <br />