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PE�tMIT FEE CALCULATI03tifi{�} <br /> ; BASED QFF-�fl02�TATE STA"�'C1E <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fi�rture or apnliance that mcets all three of the following requirements: <br /> 1. no require modification to electrical or gas service. <br /> 2. Has a to�t l�s�of$500.00 or less;ex lu 'n the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip ne�section,if this applies; Cost of Permit $ 15.00 <br /> State Surchazge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> PE;Ri4IIT FEE CALCULATION S -JOB�4VER$SOO.Q4 <br /> If above dces not apply;follow guidelines below: <br /> 1. CONTRAGT PRICE *is 1.25%of contiact price with a(Minimum Fee of$50.00) <br /> 3yav.vt� x.oi2s$ So.� <br /> (conUact price) (minimam 550.00) <br /> 2. STATE SURCFIARGE <br /> �3yoo�.000s $ �. �d <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERNIIT FEE(Add Lines 1-3 Above) S J��•7 v <br /> ■ s CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted 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 aze 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 signed copy of the actual contract. <br /> R�EC��ICAt,PE,RN�T,�'PL�ATIUI"�A+G�EEMENT <br /> The undersigned hereby applies to the City for issuance of a Mecharucal 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 aze complete, true and <br /> correct. <br /> Applicant's Signature: ���—� Date: O /d" 2, <br /> Reset Form <br /> 3 <br />