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. � <br /> PERMIT FEE CALCULATION(S) <br /> BASED OFF - ?00? 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. lloes not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;exdudine the cos[of the fi�cture 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 Petmit $ I 5.00 <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 dces not apply,follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> ��SDO x.0125$ /U�P-�� <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE `, <br /> � �� x .0005 $ �T� � <br /> , <br /> (contract price) <br /> 3. POSTAGE&I3�NDLING(Only on Mail-In Applications) $ <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ /�t�.�� <br /> ■ * CONTRAC'T PkICT or JOB COST means the actual or estimated dollar amount charged for the <br /> pernutted 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 fumished by <br /> the owner,tenant or any other party,the reasonable market value of such items mus�t be added to the <br /> estimated cost or contract price for perntit fee purposes. In the event that there is a dispute on the <br /> amount of the job cost, the City may request the subtnission of a signed copy of the actual contract. <br /> MECHAIVICAL PERMIT APPLICATION AGREEMENT <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> work in stnct 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 /> r� <br /> ApplicanY s Signatur . ti Date: � -(p-�� <br /> Reset Form <br /> 3 <br />