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► <br /> -- ._ _ ___ -- -- ---- --- ____ � <br /> PERMIT FEE CALCULATION(S) � <br /> BASED OFF-2002 STATE STATUE <br /> ❑ Yes,this section applies <br /> The replacement ot'a Residential tixture or appliance that meets all three of the following requirements: <br /> 1. Does not require moditication to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;exciudine 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;follo�v guidelines below�: <br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> 3575�� a.o�2s $ <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> x.0005 $ <br /> (contract price) <br /> 3. POSTAGL&1�[ANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> * CON'I'RACT PR1C1; or .10[3 COS"f ineans the actua] or estimated dollar amount charged for the <br /> permitted work including materials, labor, protit,and other fixed costs. It is the amount to be cha�ged <br /> to the customer for the work done. If'any material, equipment, labor or installations arc furnished by <br /> the owncr, tenant or any other party, the reasonable market value of such items must be added to the <br /> estimated cost or contract price 1or 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 City and the regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: .,� Date: f� l �J � L" <br /> 3 <br />