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. �ERMIT FEE CALGL'LATI�OIV(S) . <br /> .. , RASET3 OFF-2�0�STt�TE STATCfE , � <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance that meets all three ofthe following requirements: <br /> 1. Does not reyu'v.e modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;earcludin¢the cost of the fixture or appliamce: and <br /> 3. Is improved,installed or replaced by fhe homeowner or licensed contractor. <br /> Skip next section,if this applies; C�st of Permit $ �S,pa <br /> State Surcharge $ 1.(?0 <br /> Mail-In Fee(I£Applicable) $_ 2.ao <br /> Total Permit Fee $ <br /> '1'E�A�IIT�'EE'iCAI,�ULATIQ�1 S :-.JO�S-�'V�R�SUUO�.Q� ; ' .; . <br /> If above does not apply;fo]low guidelines below: <br /> 1. CONTRACT PRICE "is 1.25°'0 of contrad price with a(Minimam Fee of�5(1.00) <br /> d� x.0125$ <br /> (c ntract price) (rninin�nm S50A�) <br /> 2. STATE SURCHARGE <br /> x.0005 � <br /> (contract pricc) <br /> 3. POSTAGE&HANDLING(Qnly on Mail-In Applications} $ 2,pp <br /> 9. TOTAL PERMIT FEE(Add Lines l-3 Above) $ <br /> ■ * CONTRACT PR10E or JOB COST means the actual or estimated daIlar amour�t charged for the <br /> permitted work including matetials,labor,profrt,and other 6xed costs. It is the amount to be charged <br /> to the customer for the work done. If any material,equipment,]abor or installations are furnished by <br /> the owner,tenant or any other party,the reasonable market value of such items must be added to ihe <br /> estimated cost ar concract prfce for permit fee purposes. In the event khat there is a dispute on the <br /> amoun#of the job cost,the City may request the submission of a signed copy of the actual contract. <br /> , MECHANICAk�PER.IvIIT APPL�CA.TiiO�T AC'�R�EMENT <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> work in striet accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statemen�s made on this application are complete, irue and <br /> correct. <br /> Applicant's Signature: �� Date: � �^ /� <br /> 3 <br /> £'d 09L89L9£9L 6ui}eaH W'8� d�L�LO 9 6 LO��O <br />