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. <br /> PERMIT FEE CALCUI..ATION(S) <br /> � BASED OFF - 2002 STATE STATUE <br /> ❑ Yes,this section 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;excludine 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 F� CALCUL�TION S =rdBS OVER �� , .� ;`_' � ry�_` 'v,{ `�' <br /> �� ._ � . � <br /> , � . �� , _ ��� �,�,,,��- <br /> [f 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 /> �/� �\ j�� � C � <br /> � , �l�C.i i �U x.0125 $�''`.Jl ' � ��i �� - � <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE � � ✓���� �� x.0005 $ � ��� <br /> O( <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.� <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 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 ar contract price for permit fee purposes. [n 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 /> � . - � <br /> ,;= �IEC = � °ti N AGREEME ,a` <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> work in strict accordance wi the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies th all statements made on this application are complete, true and <br /> correct. <br /> Applicant's Si nature: ✓ te: �j <br /> 3 <br />