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-- - <br /> ���� PERMIT F�E CALCULATION(S) �`�� �� <br /> �� BASED aFT - 200'?�����STATE 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;excludin�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 Permit Fee $ <br /> . . ����� _��`�:���:ALCULA'�� :,... �:���s R�500.Ot��.M <br /> If above does not apply; follow guidelines below: <br /> l. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> �� , � X .0125 $ 5�� � <br /> �(contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE r/� �'j-�� / S <br /> / � �� �/(�' x.0005 $ � <br /> (contract price) <br /> 3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ v �� `' � <br /> ■ * 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. ]f 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. ln 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 /> ' ��: '�° ,� <br /> �. .... >: nn. . . _ . : _ - <br /> , ; <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do ali <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 /> Applicant's Signature: Date: �/"` � �`�' <br /> 3 <br />