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PERMIT PEE CALCULAT(ON(S) <br /> BASF,D 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 /> I. Does not require modification to electrical or gas service. <br /> ?. Has a total cost of$500.00 or less;excludin�the cost of the fixture or appliance: and <br /> 3. Is improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip�1ext section,if this applies; Cost of Permit $ 15.00 <br /> State Surchar�e $ 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 /> �2 Dc�c�. �?� x.ot25 � ��.C'� <br /> (contract price) (minimum$50.00) <br /> 2. S7�ATE SURCHARGE <br /> �DG�'�' c:�C� X .000s $ /DD <br /> (contract price) <br /> 3. POSTAGE& HANDLING(Only on Mail-[n Applications) $ 2.00 <br /> =1. TOTAL PERMIT FEE(Add Lines 1-3 Above) � 7��-�� <br /> ■ " CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> per�nitted 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 far 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 /> MECHANTCAL PERMIT APPLICATION AGREEMENT <br /> The undei-signed 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 /> MinnesoCa, and certifies that all statements made on this application are eomplete, true and <br /> correct. <br /> Applicant's Signature: � G�it� G�y�J��– Date: � — �����'' <br /> Reset Form <br /> 3 <br />