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PERMIT FEE CALCLTLAT�ON(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 the following requirements: <br /> 1. Does not require modification to electrical or oas service. <br /> 2. Has a total cost of$�00.00 or less;excludinQ 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 $ 1�.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicablel $ Z.00 <br /> Total Permit Fee $ <br /> PERIvIIT FEE CALCtTLATION(S)—JOBS OVER$500.00 <br /> If above does not apply;follow guidelines below: <br /> 1. COVTR4CT PRICE * is 1.?�°�o of contract price with a(Minimum �ee of��0.00) <br /> 'T�vO� •�� x .O1?� � J'� �.Sd <br /> (contrxt pricej (minimum S�O.UO) <br /> '_'. ST_4TE SL'RCHARGE O� �OU <br /> ��o X.000s � a •3(� <br /> (contract price) <br /> 3. POSTAGE&:Y.ANDLP.vG(On�y on�1ai1-In Applica:ions) � ?.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) � V �•�� <br /> ■ * CONTR�ICT PRCE or JOB COST means :he ac,ual or estimated doliar amount charsed for the <br /> permitted work including materials, labor, profit, and other fxed costs. It is the amount to be charQed <br /> to the customer for the work done. If any material, equipment, labor or instaliations are furnished by <br /> the ow�ner, tenant or any other party, the reasonable market value of such items must be added to the <br /> es;imated cost or contract price for perr.iit fee pu:poses. 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 undersianed hereby applies �o the City for issuance of a Mechanical Permit, aarees 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: • Date: 0 /Z <br /> Reset Form <br /> 3 <br />