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PERMIT FEE CALCU TION(S) BASED OFF -2002 STA E STATUE ❑ Yes,this section applies The replacement of a Residential fixture or appliance that me s 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. Ts improved, installed or replaced by the homeo er or licensed contractor. Skip next section, if this applies; Cost of ermit $ 15.00 State S charge $ 5.00 Mail-In ee(If Applicable) $ 2.00 Total P rmit Fee $ PERMIT FEE CALCULATION S JOBS OVER $500.00 If above does not apply; follow guidelines below: 1. CONTRACT PRICE * is 125%of contract p 'ce with a(Minimum Fee of$50.00) 3�� x.0125 $ S�'� (contraCtpric ) (miniroum$50.00) 2. STATE SURCHARGE � 3 �� ' x.0005 $ I• 5 � (contract pric ) 3. POSTAGE&HANDLING(Only on Mail-In Ap lications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �3•Sv • * CONTRACT PRiCE or JOB COST means the actua or estimated dollar amount charged far the permitted work including materials, labor, profit, and ot r fixed costs. tt is the amount to be charged to the customer for the work done. If any material, equ' ment, labor or installations are furnished by the owner, tenant or any other pariy, the reasonable mar et value of such items must be added to the estimated cost or contract price for permit fee purpose In the event that there is a dispute on the amount of the job cost, the City may request the submi sion of a signed copy of the actual contract. MECHANICAL PERMIT APP IC TION AGREEMENT The undersigned hereby applies to the City for issuanc of a Mechanical Permit, agrees to do all work in strict accordance with the ordinances of the ity and the regulations of the State of Minnesota, and certifies that all statements made on this application are complete, true and correct. Applicant's Signature: /i' '�� Date: �r t7 1 I Reset Form 3