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� ° PERMIT FEE CALCULATION(S) <br /> BASED �FF -20Q2 STATE STATUE <br /> ❑ Yes,this secrion applies <br /> The ieplacemenf of a Residential tixture or appliance that meets all three of the foilo�vine requirements: <br /> 1. Does not require modification to electrical or gas sen�ice. <br /> 2 Has a total cost of 550Q.00 or less:escludin_the cost of the fixture or appliance: and <br /> 3. Is improved,installed or regiaced by the homeowner or licensed contractor. <br /> Skip i1e�t section,if this applies; Cost of Permit � 1�.00 <br /> State Surcharge S .�0 <br /> Mai]-In Fee(IfApplicable) S 1.�(? <br /> Total Permit Fee � <br /> � PERMIT FEE CALCULATION(S}—3�BS O�'ER $SC0.00 <br /> If above does not apply;follo�v auideiines belo���: <br /> i. CONTR�iCT PRICE �` is 1.2�°l0 of contract price 1a�ith a{i�Zininaum Fee of S35.U0) <br /> 02�'�,'' x .0125� �� � <br /> (conhact price) (minimum 535.40} <br /> 2. STATE SUI2CHARGE *�`Add the State Blds Gode Div.Surcharge(i�iinimum Fee of s.�0) <br /> ��/� � x .Q00� � � ��" <br /> �contract price} (minimum S .50) <br /> 3. POSTAGE R HANDLIIvG(Onh�on vlail-In Applications} � L�0 <br /> � 4: TOTf1L PER��IIT FEE(.add Lines��-3 Above) �� � � � � �@,'f'f�c�� �� � <br /> • " CONTR4CT PRICE or JOB COST means the ach�al or estimated dallar amount chareed for the <br /> pemvtted���ork includinQ materials_, labor,profit, and other fised costs. It is the amowit to be chzr�ed <br /> to the customer foi- the ���ork done. If any material, equipinent, labor or installations are furnished by <br /> thz ow7�er, tenant or any other parry•, ale reasonable market value of sucli items must be added to the <br /> estiinated cost or contract price far pernvt fee;purposes. In the event that there is a dispute on the <br /> amouiit of the job cost, the City m3y request tl�e �ubmission of a si�ned copy of the aetual contract. <br /> ° "'The STATE SURCHARGE is .0005 of the Buildin�Department at(9�2)2=19-46Q0 for tlie price. <br /> MECHA.iVICAL PERMIT APFLICATION AGREE�NT <br /> The undersi��ed hereby applies to the City for issuanc� of a i�lechanical P�rmtt, aarees to do all <br /> �i•orl: in strict accordance �vith the ordinances of ihe Cit�� and the re?ulations of the State of <br /> :��Iinnesota, and czrtifies that all statements made on this application are complete, truz and <br /> correct: <br /> Applicant's Si�ature: l.L� �. Date: ���—�� <br /> 3 <br />