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03-12—'18 09:22 FROM— 1-632 P0003/0004 F-093 <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;excluding 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 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 s is 1.25%of contractp rice with a(11,1mimurn Fee of$50.00) <br /> l (I , c012, , =r ,� <br /> ' <br /> 2. STATE SURCHARGE Z f l v/ <br /> —L.0*-tliri )) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) ) ,,:;.,.••,"%,� <br /> to <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) r,;,;,; ,,, ,.. ,,, ,•, $,, <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 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 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 Cit and the regulations of the State of <br /> Minnesota, and certifies that all statements made • ' s application are complete, true and <br /> correct. <br /> Applicant's Signature: 1 itl` 71 t � 1��8 <br /> 3 <br />