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PERMIT FEE CALCULATION(S) <br /> BASED OFF - 2002 STATE STATUE <br /> ❑ Yes,this section appiies <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;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(Minimum Fee of$50.00) <br /> � �L'�-' � ��-� x .O l 25 $ �� . ��� <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> L-,�C c_, c-�-_ X .000s � �3 i S <br /> (contract price) <br /> 3. POSTAGE& HANDLING (Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �.?j �<<� <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. [t 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 /> amount o;the job cost, the City may request the submission of a signed copy of the actual contract. <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 w' the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that I1 statements made on thi ����application are complete, true and <br /> correct. ' �� <br /> � <br /> y �` t <br /> Applicant's Signature: ��� � � � �` : Ci'' Date: � � ��� <br /> i <br /> , <br /> � �.._� <br /> 3 <br />