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. <br /> ?:P�RIv�T�EE CALCU�.ATIQN S �. <br /> ._:` <br /> � � <br /> . � . <br /> BASED(�FF- 2t�a2 S�TATE �FAT�E ' <br /> ❑ Yes,this section applies <br /> The replaCement of a Residential fixture or alpliance that meets all three of the following requireme ts: <br /> l 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 /> 3i Is improved, installed or replaced by the homeowner or licensed contractor. <br /> ' Skip next section,if this applies; Cost of Permit $ 15.0 <br /> State Surcharge $ 1.0 <br /> Mail-In Fee(If Applicable) $ 2.0 <br /> Total Permit Fee $ <br /> P�:�MIT FEE C.A�CLTL:A��}� S �-7Q��t�iT��:'��(��}.Otl <br /> If above d�es not apply;follow guidelines below: <br /> 1: CONTRACT PRICE * is 125%o contract price y✓ith a(Minimum Fee of$50.00) <br /> I �� . � X.oizs $ <br /> (contract price) (minimum 550.0 ) <br /> 2. STATE SURCHARGE <br /> x.0005 $ <br /> (contract price) <br /> 3.I POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4.I' TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> • * CO�TRACT PRICE or JOB COST means the actual or estimated dollar amount charged or the <br /> permi ed work including materials, labor,profit, and other fixed costs. It is the amount to be c arged <br /> to the customer for the work done. If any material, equipment, labor or installations are fumis ed by <br /> the o�ner, tenant or any other party, the reasonable market value of such items must be added to the <br /> estima�ed cost or contract price for permit fee purposes. In the event that there is a dispute n the <br /> amount of the job cost, the City may request the submission of a signed copy of the actual c tract. <br /> IvIECHAN��AL PERMIT`.APFL��'�TI��A,G�E�4�1'`T �: <br /> 4,'! <br /> The under�igned hereby applies to the City for issuance of a Mechanical Permit, agrees to o all <br /> wark in strict accordance with the ordinances of the City and the regulations of the St te of <br /> Minnesota�, and certi�es that all statements made on this application are complete, tru and <br /> correct. � <br /> Applicant"s Signature: Date: / <br /> 3 <br />