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P�R�tT F��C�LCC�TIQ�T{�}: <br /> ���D��.,�2����S"�A�;.,. <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance that meets all three of the following tequirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a tal cost of$500.00 or less;excluding 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 Swcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $^ 2.00 <br /> Total Permit Fee $ <br /> FER�IIT FEE CALGUU�t�'TI(�N � .:-J�}&S-���:'�50�?�U <. . <br /> If above dces not apply;follow guidelines below: <br /> � ,�� 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimam Fee of$50.00) <br /> fr,�`� � 0��• l� U X.oi2s� � � 2'�� <br /> � (contrad price) (minimam 550.00) <br /> ��� <br /> �, 2. STATE SURCHARGE �n�o. ou X.o�s $ � ��o <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S 1, � G� v � <br /> • * CONTRAC'f 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 are fiunished 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 tt►e 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 /> MECHA1�tI�AL PE�L1VCi'I`t�FF�.I��lTifl�1�f`.�i�EArt�' . <br /> The undersigned hereby applies to the City for issuance of a Mechanical Pennit, 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 a11 statements made on this application are complete, true and <br /> corre�t. <br /> � <br /> ApplicanYs Signature: Date: 1, � �O <br /> 3 <br />