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� <br /> � ����l1rIIT�EE CALCULATIQ�(S� <br /> BASED OFF-2002 5'TATE STATUE <br /> ❑ Yes, this section applies <br /> The replacement of a Residential fixture or aQpliance 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;excludinQ the cost of the fix[ure 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-[n Fee(If Applicable) � 2.00 <br /> Total Permit Fee $ <br /> [�� ���������:����c���-�r�s�Q��R��ar.o� -� <br /> If above does not apply: follow guidelincs below: <br /> L CONTI2ACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> y5o� X .o�25� 5�. `d� <br /> (contract price) �minimum$�U.UOj <br /> 2. STATE SURCHARGE � <br /> y� � .���5 � a.a5 <br /> (contract pricc) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � . ,_Z�� <br /> ■ ''' CONTRACT PR10E or JOB COST means the actual or eslimated dollar amount charged for the <br /> permitted work ineluding materials, labor, profit, and othcr fixed costs. It is th� amount to be charged <br /> to lhe customer for the work done. If any material, equipmcnt, labor or installations are turnished by <br /> the owncr, tenant or any other parly, the reasonable market value of such items must be added to thc <br /> estimated cost or con�ract price for permit fce purposes. In the event that there is a disputc on the <br /> amounl of the job cosl, the City m�y reyuesl the submission of a signcd copy of the aclual contract. <br /> NiECHANICAL PERMIT APFLICATION AGREEMENT' <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> work in strict accordance with the ordinances of the City and the regulaCions of the State ��f <br /> Minnesota, and certifies that all statements ma�e on this application are complete, true ancl <br /> correct. <br /> Applicant's Signature: � ���� Date: 3��� ���--- <br /> ��l88� ff'3t'�Yl <br /> 3 <br />