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• PERMIT FEE CALCULATION(S) <br /> BASED OFF-2002 STATE STATUE <br /> ❑ Yes,lhis sectiun applies <br /> The repiacement of a Residential ftxture or ap�liance that meets all three of the following requirements: <br /> 1. Does not require modi�ication to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less,exeludina the cost of the tixture or appiiance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip next section,if this applics; Cost of Permit $ I5.00 <br /> State Surcharge $ I.00 <br /> Mail-In Pee(If ApplicTble) $ 2.00 <br /> futal Permit Pcc $ <br /> --- —-- <br /> PERMIT FEE CALCULATION(S)—JOBS OVER$500.00 <br /> If above does not apply,follow guidelines below: <br /> L CONTRACT PRICE *is 1.25%of contract price with a(Minimum I�ee of$50.00) <br /> ^} � <br /> t74,��� x.012�$ <br /> (comrac�pnce) (minimnm$50.00) <br /> z. s�rATF suacE�AacF <br /> X.000s � <br /> (contract price) <br /> 3. POSTAGG&HANDLWG(Only on Mail-In Applications) $ 200 <br /> 4. 'f'O'I'AL PGRMIT FFF.(Add Lines 1-3 Above) $ <br /> * CON"fRACT PRICG or J013 COST means the actual or estimated doliar amount charged f<>r the <br /> permitted work including materials,labor,profit,and other tixed 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 /> tlie 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 /> MECHANICAL PERMIT APP:I��GATI�N AGREEMENT <br /> "I'he undersigned hereby applies to the City for issuance ol�a Mechanical Permit, agrees to do all <br /> work in strict accordtu�ce with the ordinanecs of the City and the regulations of the Stute of <br /> Minnesota, and ecrtilies that all statements made on this application are complete, true and <br /> correct. <br /> Applicant'sSignature: Date: � 6 �QI � <br /> 3 <br />