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� PER�IIT FEE CALCULATI(�N(S)� <br /> BASED�FF -�UO2 S"I'ATE STATUE <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance 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;excludine 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-In Fee(If Applicable) $ 2.00 <br /> Total P�rrnet F�e $ <br /> � �`� " <br /> r ��; � H���: �...: ��� ��� � <br /> `� ��k�, ���,��� . «� ,; <br /> ..,...,.f. . �.o.,�F 1,�� �., „{ � <br /> _ . , ._.,..„ ..�. .... ��:,.a�..s:' <br /> If above does not apply;follow guidelines below: <br /> i. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> ��% � � � <br /> � lJ'� x .0125 $ �� �S �)�� <br /> (contract price) (mmimum$50.00) <br /> 2. STATE SURCHARGE �' -, i � �—� <br /> �" �`� x.0005 $ ' � <br /> (c tract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � <br /> � <br /> ■ * CONTRACT PR[CE or JOB COST means th� 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 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 /> �� � .. . <br /> �� ..�,�,..� s�, . ; ��s� ��`��F ...���`t�.€��EEI�iENT >a� <br /> ,�., <br /> ��� _.. z- <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 all statements made on this application are complete, true and <br /> correct. <br /> `� `��- a-----� <br /> Applicant's Signature: Date: ,� � <br /> 3 <br />