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PERMIT FEE CALCULATION(S) <br /> BASFD OFF - 2002 STA"TE STATUE <br /> ❑ Ycs,this scction 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 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-:r.Fe.,(If Applicable) $_ 2.00 <br /> Total Permit Fee $ <br /> PERMIT FEE C�LCU�ATION 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(Minimum Fee of$50.00) <br /> 3Gc���. �o X .oi2s$ ��c�C? <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE �, � <br /> "3� O�'_ C�� X.000s $ f� 5 � <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <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 wark 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 /> 3111"JU7t C�ili0�J'"v CGS.� :��i� l.?r'y' !718j'1.,cNii:;S: t�:C'. �u�'?71:SS:0:: O; & Sib iAL :,v�'y' O;�i}:: 2.C�U3: Cil?1�:f1L'i. <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: ��`L �/�'�r''— Date: � Z'7�12`� <br /> Reset Form <br /> 3 <br />