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PERMIT FEE CALCULATION(S) <br /> BASED QFF -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 $ .50 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> FERNITT FEE CALCULATION S -JOBS OVER$SOO.OQ <br /> If above does not apply; follow guidelines below: <br /> l. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> Si ��t) � x .0125 $ ��`�: �� <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of�.50) <br /> S1 ��'t� � x .0005 $ ����] ✓� � <br /> (contract price) (minimum$ .50) <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 work including materials, labor, profit, and other fixed costs. It is the amount to be charged <br /> to the customer for the work done. lf any material, equipment, labor or installations are furnished by <br /> the owner, tenant or any other party, the reasonabie 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 of the job cost, the Ciry may request the submission of a signed copy of the actual contract. <br /> • ** The STATE SURCHARGE is .0005 of the Building Department at(952)249-4600 for the price. <br /> ,�`' `' MECHAI�TICAL PERMIT APPLICA'TTQI�AGREEIV�NT' <br /> The undersigned hereby applies to the Ciry for issuance of a Mechanical Permit, agrees to do all <br /> work in strict accordance with the ordinances of the 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 /> � ,� O�—v7 —// <br /> Applicant's Sibnature: � <f- Date: <br /> Ft@Set FO�m <br /> � <br /> � <br />