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PERMIT FEE CALCULATION(S) <br /> BASED OFF-2�12 S"TATE 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 modificarion to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excluding the cost of the fixtute 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 $ I5.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> PFsRI�'.FEE CALCU�ATI4N S �-�JBS 4VEIt.�SUO.UO <br /> If above does not apply;follow guidelines below: <br /> l. CONTRACT PRICE *is 125°/a of contract price with a(Minimum Fee of$50.00) <br /> 3��.vt� X.o�2s$ 5�0.vt� <br /> (contract price) (minimum 550.00) <br /> 2. STATE SURCHARGE <br /> 3�0'D.�,T� x.0005 $ l. Co D <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ .s.3.�O <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 chazged <br /> to the customer for the work done. If any material,equipment,labor or installarions 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 /> IV�CHA�3��1�;L`PE�1�A�T��LIC�lT�C31�A+CiR;EEMLIV'I' : <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 on this application are complete, true and <br /> correct. <br /> Applicant's Signature: -`�� Date: � /� 02 <br /> R@$+@t fCH"17i <br /> 3 <br />