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�� . PERMIT FEE C�LCUi,�TION(S) � �� BASED OFF - 2002 STATE STATUE�� ❑ Yes,this section applies The replacement of a Residential fixture or appliance that me ts all three of the following requirements: 1. Does not require modification to electrical or ga service. 2. Has a total cost of$500.00 or less;excluding th cost of the fixture or appliance: and 3. is improved,installed or replaced by the homeo ner or licensed contractor. Skip next section,if tliis applies; Cost of Permit $ 15.00 State S rcharge $ 5.00 Mail-I Fee(If Applicable) $ 2.00 Total ermit Fee $ PERMIT FEE CALCULATTO. � ' �+(�B�f�"�ER.�5�0,�?� If above does not apply;follow guidelines below: 1. CONTRACT PRiCE * is 1.25%of contract ice with a(Minimum Fee of$50.00) � �� x .0125 $ �� (contrac[pri e) (minimum$50.00) 2. STATE SURCHARGE /-� �UV x .0005 $ �' � (contrac[pr'ce) 3. POSTAGE&HANDLING(Only on Mail-In A plications) $��_ 4. TOTAL PERMTT FEE(Add Lines I-3 Abovc $ � S ' � � ■ * CONTRACT PRTCE or JOB COST means the ac I or estimated dollar amount charged for the permitted work including materials, labor,profit,and o her fixed costs. It is the amount to be charged to the customer for the work done. If any material, eq ipment, labor or installations are furnished by the owner, tenant or any other party, the reasonable m rket value of such items must be added to the estimated cost or contract price for permit fee purpos s. In the event that there is a dispute on the amount of the job cost, the City may request the sub ission of a signed copy of the actual contract. � MECHANICAL�'ET�MTT � ATIU�3 A�REEMENT The undersigned hereby applies to the City for issuan e of a Mechanical Permit, agrees to do all work in strict accordance with the ordinances of th City and the regulations of the State of Minnesota, and certifies that all statements made n this application are complete, true and correct. Applicant's Signature: Date: � � � Z Reset Form 3