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; PERMIT FEE CALCULATION(S) <br /> � BASED OFF - 2002 STATE STATUE j <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance that���eets all three of the following requirements: <br /> 1. Does not require modification to electrical or gas seivice. <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 conh-actor. <br /> Ship next section, if this applies, Cost ot Permit � 1�.00 <br /> State Surchar�e � 50 <br /> Mail-In Fee(If�Applicable) $ I.�O <br /> Tot:�l Permit Fee $ <br /> PERMIT FEE CALCULATION S —JOBS OVER $�00.00 <br /> lf above does not apply; follow guidelines below: <br /> I. CON"1'RAC"1' NRICE * is I?�°ro of contract price with a(Minimum Fee of$35.00)� <br /> � � sa 9 <br /> ��3 `� . .oi�� � /03 <br /> (cuntract pnc�) I ininimum b3�UU1 <br /> 2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(�linimum Fce of�.�(I) <br /> � ���19 °' � 6 <br /> X .000s � / <br /> (cuntrac[pricrl lnunimum$ SOl <br /> 3. POS��AGE& HANDLING (Only on Mail-In Applications) $ 1.50 <br /> IS <br /> 4. TOTAL PERn11T FEE(Add Lines 1-3 Above) $ ��� <br /> • * COI�TRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> �ermitted work including materials, labor, profit, and other tixed costs. It is the amount to be char�ed <br /> to the customer for the work done. [f a��y material, equipment, labor or installations are furnished bti <br /> the owner, tenant or �ny other party, the reasonable market val�ie 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 oYthe Quildin�Department at(9�2)249-4600 for the price. <br /> MECHANICAL PERMIT APPLICAT[ON AGREEMENT <br /> �l�he undc:rsigned hereby applies to the City for issuance of a Mechanical Permit, agrees to c10 all <br /> wurk in strict accordance with the ordinances of th� 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 /> �� <br /> Applicant's Signature: Date: �� i �� <br /> Reset Form <br /> 3 <br />