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PERMIT FEE CALCULATION(S) � <br /> BASED OFF -2002 STATE 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 modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludine 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 Surcharbe $ 5.00 <br /> Mail-tn Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> PERMIT FEE CALCULATION S —JOBS OVER $500.00 <br /> [f above does not apply; follow guidelines below: <br /> 1. CONTRACT PRICE * is I.25%of contract price with a(Minimum Fee of$50.00) <br /> � , �!' 4C� <br /> u �ri, � -- X .0�25 $ 75�-- <br /> (��ntract price) (minimum$5U.00) <br /> 2. S7'ATE SURCHARGG �"�, ��. � ����� <br /> J x.0005 $ <br /> (cuntract price) <br /> 3. POSTAGE&HANDLWG(Only on Mail-In Applications) $ 2.00 <br /> ��� ��, <br /> 4. TOTAL PERMIT FEE(Add Lines I-3 Above) $ <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor,pro�fit,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 /> IVIEGHANICAL PERMIT APALICATION AC'rR�EMENT <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, ag�rees 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 /> , <br /> A licant's Si nature: \��\Y\�-J Date: - � - �� <br /> rr � <br /> 3 <br />