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l <br /> _ _ ..__ <br /> __ _ <br /> PERMIT FEE CALCULATI�7N(S) <br /> BASED (�FF- 2002 STaTE STATUE <br /> ❑ Yes,this section applie� <br /> The replacement of aResidential fixture or appli�uice tha�meets all three ofthe following requirements: <br /> 1. Does n,ot require mod�cation to eleckrical or gas ser�ice. <br /> 2. Has a total cost of$500.00 or less; excluding the cost of the fi.�ture or appliance: and <br /> _ <br /> 3. Is impmved,installed or re�laced by the homeowner or licensed contractor. <br /> Skip next section, ifthis applies; Co�t ofPermit $ 15.00 <br /> _.. _. <br /> State Surcharge $ ___ 5.00 <br /> Mail-In Fee {If Applicable} $______2.OD <br /> Total Permit Fee $ <br /> _____ __ __ � <br /> PERI�IIT FEE C.4LCUL4TI�N(S�—JOBS_OVER$500.00 � <br /> If above does not a��ply;follow guidelines below: <br /> L CONTRACT PRICE * is 1.259�0 of contract price with a(Minimum Fee of$50.00) <br /> .�}-�.�0 x.0125 $ ���� <br /> (contract pnce) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> 3��c' K .000s $ � . �� <br /> (c ontract pric e) <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«�o� including materials, labor,profit,and other fixed costs. It is the amount to be charged <br /> to the customer for the wo� 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 pern�it 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 /> MECHANIGAL PERMIT APPLICATIt�N AGREEMENT <br /> The undersigned hereby a��plies to the City for issuan�e of a Mechanical Peirnit, agrees to do all <br /> work in strict accordance wit}i the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all �tatement-s made on this application are complete, true and <br /> co�rect. <br /> a, <br /> �--� .- <br /> Applicant's Signatur . a..-. Date: '� � )_G� / �j <br /> --� <br /> 3 <br />