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� _�,. <br /> rERMIT 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;excluding the cost of the fixture or appliance: and <br /> 3. Is improved, installed ar 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 l.25%of contract price with a(Minimum Fee of$50.00) <br /> �� , �� � U: <br /> ���v X .oizs $ <br /> (contract price) � (minimum�50.00) <br /> 2. STATE SURCHARGE �`-' <br /> ,����=� X .000s $ l, /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) $�.� , I � <br /> ■ * CONTRACT PWCE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor, protit, and other�xed costs. It is the amount to be charged <br /> to the customer for the work done. If any material, equipment, labor ar 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 purpo5es. 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 certi�es that all statements made on this application are complete, true and <br /> correct. <br /> (�, - ,, r,'� ,,. <br /> �, � <br /> _ � �, � — � � <br /> Applicant s Signature:�;, Date: �� � <br /> � � <br /> 3 <br />