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�'�.1T�E CAL�UL�"1���) . <br /> BA��D t)►FF-20U2 S'�"A'�E:3TA'i't1� <br /> ❑ Yes,this section applies <br /> The replacement of a Resid�tial fiadure or aonliance that meets all three of die following requirements: <br /> 1. n t require modification to electrical or gas service. <br /> 2. Has a tot of�500.00 or less;�xclu�the cost of the fixture or appliance:�nd <br /> 3. Is improved,installed or replaced by the homeowner or lice,nsed 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 S <br /> ���r�e�t.cur.��� � �-a�vs�c���+� <br /> If above does not apply;follow guidelines below: <br /> 1. CO�j,'�'RACT PRICE *is 1.25%of contract price with a(Minimam Fee of SS0,00) <br /> � <br /> �/.t1Uy x.012S� y p � <br /> (Tcent�t price) (miaimum SS0.99) <br /> 2. STATE SURCHARGE <br /> � /.�U� � x.0005 $ •S� <br /> (contirracc price) <br /> 3. POSTAGE&HANDLING(qnly on Mail-In Applications) S 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ S v <br /> i <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollaz amount charged for the <br /> permitted work including materials,IaUor,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 pariy,the reasonable matket value of such items must b�e 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 tha submission of a signed copy of the actual contract. <br /> 1�ECHAI�3ICAL PERtVIIT APp�l�,`�'���`'i�M��`; <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit,a�rees to do all <br /> work in strict ac�ordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statemen ade on this application are complete, true and <br /> correct. <br /> ApplicanYs Signature• Date: .� � �f� � <br /> 3 <br />