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' PCRMIT FCC CALCULATION(S) <br /> �� � BASCD OFF - 2002 STAT� STATUE � � � � � <br /> ❑ Yes.this section applies <br /> T�he replacement of�a Residential fixture or appliance that mcets all three of the ti�llowing requirements: <br /> L Uoes not require moditication to electrical or gas service. <br /> 2. Has a total cost of$�00.00 or Icss;excludi!ia the cost ofthe fixture or appliance: and <br /> 3. Is improved, installed or replaced by lhe homeo���ncr or licensed contractor. <br /> Skip next section. if this applies; Cost of Permit $ 15.00 <br /> Statc Surcharge $ 5.00 <br /> Mail-In I�ee(If Applicable) $ 2.00 <br /> Total Permit Hee $ <br /> � ------ _ _ __ _ _ -- --- --- -- <br /> � �� � _PERMIT FEE Cr'.LCULATIGN�S� JOF3S OVER $SG0.00 _� <br /> If�above doe�not appl��: follo�v guidelines belo���: <br /> I. CONTRACT PRICE * is 1.25%of contract pricc wilh a(Minimum Fee of$50.00) <br /> �J . r� <br /> ���� ��� x .0125$_ / <br /> (contracl pricc) (minimum�50.00) <br /> � � <br /> 2. STATE SURCHARGE � � �� i' � ..`� <br /> � c'�` h .000� $ <br /> (contract price) <br /> 3. POSTnGE&f InNDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PFRMIT FEE(Add Lines 1-3 Above) $ � ��� � `� � <br /> � * CONTRAC"l� PRICF, or JOB COS"I' means the actual or estimatcd dollar amount charged for the <br /> permilted ���ork including materials, labor. protiL and othcr tixed costs. lt is thc amount to bc charged <br /> to lhe customer for the �vork dune. If anv materiaL cyuipment. labor or installations are furnished by <br /> the o���ner. tenant or anv other party, the reasonablc market value of such items must be added to the <br /> estimated cost or contract price fiir permit fee purpuses. In the c��ent that there is a dispute on the <br /> amount of the joh cosl. thc City may request the submission of a signed copy of the actual contract. <br /> MECHAN[CAL PERMIT APPLICATI(�N AGREFMENT <br /> '1�he 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 /> �- <br /> � `� � <br /> Applicant's Signature: � Date: � `������ <br /> 3 <br />