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, . <br /> � � �� �PERMIT FEE CALCULATION(S) � � <br /> � BASED tJFF - 2002 STA"I�E STATUE � � <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance 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;excludin�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-[n Fee(lf Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> PERMIT FEE CALCULATION��S)—JC)BS 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 /> ���GC? x .0125 $ ��� , �"� <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE � �� <br /> i�� �c� X.000s $ 5 , <br /> (contract price) <br /> 3. POSTAGE& HANDLING(Only on Mail-[n Applications) $ 3.00 <br /> �� <br /> 4. TOTAL PERMIT FEE(Add Lines I-3 Above) $ � ��. � <br /> ■ * CO�ITRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor, protit, 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 /> [he owner, tznant or any other party, the reasonable market value of such items must be added to the <br /> estimated cost or 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 /> 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 /> , <br /> Applicant's Signature: �`-� "'J`-�-��— (�'w�.., Date: 3`�F I 1� <br /> 3 <br />