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� � �� � � � PERl��ITT EEE GALCULATION(S) � � � � �� �� �� � <br /> � � � � � BAS��:D (��F -2002 STATE STATUE� � � <br /> � Yes,this section applies <br /> The replacement of a Residential fi�ture or ap lip ance that meets all three of the following requirements: <br /> 1. Does not require modification io electrical or gas service. <br /> 2. Has a total cost of$5OU,Ot1 or less;excludin�the cost of the fixture or ap�liance:and <br /> 3. Is improved,installed or replact.d by the homeowner or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ I5.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> � PERMIT FEE�"A�.CLTLATION(S)—JOBS OVER��SOU.00 � <br /> If above does not apply; follow guiciclines l�cl�w: <br /> I. CONTRACT PRICE * is I_2�%of contract price with a(Minimum Fee of$50.00) <br /> 4000.00 x �,,5� 50.00 <br /> (contract pricc) (rninimum$50.00) <br /> 2. STATE SURCHARGE *�` Add the State Bldg Code Div. Surcharge(Minimum Fcc of�5.00) <br /> 4,000.00 X ���5 �5.00 <br /> __. ___ ____ ____ ____ --___ <br /> (contract pricc) (minimum$�AO) <br /> 3. POSTAGE&HANDLING I.Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PF,RMIT FEE(Add Li��es I-3 Above) $55:�� <br /> ■ * CONTRACT PRICE or JOIi C'OST means the actual or estimated dollar ai�rount charged for the <br /> permitted work including material3, labor,profit,and other fixed costs. It is the�imount to be charged <br /> to the customer for the work done. If a�ny material, equipment, labor or installatii>ns are furnished by <br /> the owner, tenant or any other party, tfie reasonable market value of such items must be added to the <br /> estimated cost or contract pric� f�r �rrmit fee purposes. In the event that there is a dispute on the <br /> amount of the job cost, the City rnay request the submission of a signed copy i�f the actual contract. <br /> ■ **The STATE SURCHARGE is.O00�times the Contract Price or a minimum of b5A0. <br /> MECHANICAL PERh-1IT APPLICATION AGREEME��T <br /> The undersigned hereby applies t� the City for issuance of a Mechanical Perrtilit, 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 state.ments made on this application are eomplete, true and <br /> correct. <br /> Applicant's Signature: Date: � �/�3/�O <br /> Reset Form 3 <br />