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. <br /> PERMIT FEE CALCULATION(S) <br /> BASED OFF - 2002 STATE STATUE <br /> ❑ Yes,this secrion applies <br /> The replaceu�ent of a Residential fixture or ap lip ance that meets all three of the following requirements: <br /> I. 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-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> PERMIT FEE CALCULATION(S -JOBS OVER $500.00 <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(�biinimum Fee of$50.00) <br /> _ )-1Lx�,(JL�: x .0125 $ ��,��� <br /> (contract price) (minimum SSUAO) <br /> 2. STATE SURCI-IARGE ** Add the State Bldg Code Div. Surcharge(.14inimum Fee of$5.00) <br /> �OL.I� x.0005 $ -�` �C <br /> (contract price) (minimum$5.00) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) � 1� <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �� .�� <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 �naterial, equipment, labor ar installations are furnished by <br /> the owner, tenant ar 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 /> 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 /> Applicant's Signature:C�,��� Date: 3�-( ( <br /> Reset Form 3 <br />