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11-13-'17 15:30 FROM- T-133 P0003/0004 F-524 <br /> PERMIT FEE CALCULATION(S). <br /> EASED OFF: 2002 STATE STATUE - <br /> ❑ Yes,this section applies <br /> The-replacement-ofa-Residential-fixture-orappliance that-meets-all three of the-following-requirements: <br /> L Does not require modification to electrical or gas service. <br /> 2. Has a total 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 Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> :PERMIT FEE CALCULATION(S)-JOBS OVER$500.00 <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract <br /> ctt p � <br /> price with a(Minimum Fee of$50,0.4 <br /> 14 <br /> 2. STATE SURCHARGE L q q �j tj Q <br /> iNh{. li <br /> teg <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) a <br /> 5- q, i;;;,<�;,%�. <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) ;�.�r,:Eei:,d r, ;� :` p:.:sPr.: <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. 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 /> MECHANICAL PERMIT APPLICATION 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 regulations of the State of <br /> Minnesota, and certifies that all statements made o his application are complete, true and <br /> correct. <br /> / ". <br /> 9 <br /> �. 1/—13 /T7 <br /> Applicant's Signature: te <br /> 3 <br />