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� <br /> � . . <br /> �� — — PERMIT�} �, CALC[1LATiON(�) � �� � � <br /> _ ___BASED �FF 2Q0? STATE STATUE � � � � � � �� <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or a�pliance that meets all three of the following requirements: <br /> 1. 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-Tn Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> , PERMIT FEE C�LC�LA'�'�� ..� - �.,,Q��'�;�.��}{3:#�� ..;. <br /> 1f above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE * is 1.25"/0 of contract price with a(Minimum Fee of$50.00) <br /> . � � � , r--� <br /> � 'i��� ' �� x.0125$ r) �� �l <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE `� � � <br /> �`� I�� � ��U x .0005 $ .� �� 7 <br /> (contract price) <br /> 3. POSTAGE&HANDLiNG(Only on Mail-In Applications) $ 2.00 <br /> C� �4. 7'OTAL PERMIT FEE(Add Lines 1-3 Above) $ � � � _ <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> pernlitted 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 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 si�ned copy of the actual contract. <br /> ���������� � �T`:AP��, ��'�"T��?��,��a��.F�Iu��; �..�..�.,,�� <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 /> 3 <br />