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- Jun 1 Y 14 02:19p DL Johnson Htg. 763-434-1934 p.3 <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 f Mowing 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 sr appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed co tractor. <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 1.25%of contract price with a(Minimum Fee of$50.00) <br /> /,-yb4/ '--f x.0125$ Sv''✓ <br /> (contract price) (minimum 550.00) <br /> 2. STATE SURCHARGE <br /> .8' (,5i = x.0005 IS . 79 <br /> (contract price) <br /> 3. POSTAGE&HANDLLNG(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 6-, . , -27 <br /> - * CONTRACT PRICE or JOB COST means the actual or estimated doll r amount charged for the <br /> permitted work including materials, labor,profit,and other fixed costs. It' 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 Mems 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 dopy of the actual contract. <br /> MECHANICAL PERMIT APPLICATION AGRE I MENT <br /> The undersigned hereby applies to the City for issuance of a Mechanic. Permit, agrees to do all <br /> work in strict accordance with the ordinances of the City and the re: lations of the State of <br /> Minnesota, and certifies that all statements made on this applicatio I are complete, true and <br /> correct. <br /> Applicant's Signature: 3�- 61 2, Date; I y7 4/ <br /> 3 <br />