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r , � <br /> PERMIT FEE CALCULATION(S) <br /> BASED OFF-2002 STATE STATUE <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or a�pliance that meets all three of the following requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludine 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 Pernut $ 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;follow guidelines below: <br /> 1. CONTRACT PWCE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> ��Z��� X.oi2s$ �L�.;��7 <br /> � (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div_Surcharge(Minimum Fee of 55.00) <br /> ,�r�J�,,� x.0005 $ �`�.tl C.' <br /> (wniract price) (minimum S 5.00) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ j(���(,.� <br /> ■ # CONTRACT PRICE or JOB COST means We actual or estimated dollar amount charged for the <br /> pennitted work including materials,labor,pmfit,and other fixed costs. It is the amount to be chazged <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 ar contract price for 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 /> ■ **The STATE SURCHARGE is.0005 times the Contract Price or a minimum of$5.00. <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 /> conect. <br /> Applicant's Signature: ��y��c.� ;,"�.��r u-c��' Date: <br /> � <br /> Reset Form 3 <br /> t f <br />