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Y <br /> V <br /> � PERMII' FEI� CALC'ULATION(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;excluding 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-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee � <br /> y. <br /> � � ... ��� ���',�'� EE C'ALCVI AT�{?� �� ;-��UBS QVER$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 /> ,✓ «, <br /> �G"t�t� x .0125 $ �r� <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of$5.00) <br /> x .0005 $ � � <br /> (contract price) (minimum a 5.00) <br /> 3. POSTAGE& HANDLING(Only on Mail-[n Applications) $ 2.00 <br /> 4. 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 /> permitted 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 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 /> -, , �: _ CHANICAL P�RMIT APPLT�.l�'�"TOl''�A�R�EMENT �'' <br /> � ,� <br /> ,,..,. �._���,., <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 /> Applicant's Signature: d��%� Date: ����"�!J�l <br /> � <br /> Reset Form 3 <br />