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.9�2933�.869 18 59 13 04-01-2015 4/4 <br /> PERMIT FEE`CALCULf1TION(S) <br /> BASED OFF-2002 STATE STATUE <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance that meets all three of ihe f'ollowing requirements: <br /> l. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$5�0.00 or less;exciudine the cost of the fixture or appliance:and <br /> 3_ Is improved,installed or replaced by the homeow�ner or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ I5.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable} $ 2.00 <br /> Total Permit Fee S <br /> PERMIT FEE CALCULATION S —.7OBS'OVER$500.00 <br /> If above does not apply;follo�v guidelines belo�v: <br /> 1. CONTRACT PRICE *is I.25%of contract price witli a(Minimun►Fee of$50.00) <br /> �VL-�3.Q� x.0125$ �.Q� <br /> (contrnct pricc) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> � 25.0o X.0005 � 0.yZ <br /> (cOntracl price) <br /> 3. POSTAGE&HANDLING(Only on Mail-]n Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ��. �2. <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 rea5onable 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, tl�e City may request the submission of a signed copy of the actual contract. <br /> MECHANICAL PERMIT APPLICATION AGREEMENT <br /> The undersigr�ed liereby 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 regnlations 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. ���- Date: Q Q/ � <br /> 3 <br />