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� , <br /> A <br /> 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;exciudin�the cost of the fixture or appliance: and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Sldp 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 /> � `�,µ�:'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 price with a(Minimum Fee of$50.00) <br /> ��� �� ��� x .0125$ ( ZC��� , � 7 <br /> (contract price) (mi imum$50.00) <br /> 2. STATE SURCHARGE <br /> C��% �"I � � w x.0005 $ ��'`; Z� <br /> (c tract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERIVIIT FEE(Add Lines 1-3 Above) $ � �-C�� ;-`���'' <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 pernut 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 si�ed copy of the actual contract. <br /> �IECHt�1VICAL`PERMIT�APPLICATION AGREEM�� <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 /> t ._ --� /� � <br /> Applicant's Signature: .,,� C ` � Date: %%'��� " �� <br /> i <br /> 3 <br />