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PERMIT FEE CALCULATION(S} � BASED OFF -2002 STATE STAT�,3E ❑ Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: l. Does not require modification to electrical or gas service. 2 Has a total cost of$SOU.00 or less; excludin�the cost of the fi�cture or appliance: and 3. Is improved, installed or replaced by the homeowner or licensed contractor. Skip next section, if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ �— PERNIIT FEE CALCULATION(S)-JOBS OV�R$500 00 If above does not apply;foliow guidelines 6elow: i. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of�50.00) � x.0125 $ •� (conu�act price) (minimum$50.00) 2. STATE SURCHARGE � x .0005 $ � �S �(contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PEIi1VIIT FEE(Add Lines i-3 Above) $ ✓ / • * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including materials, labor, profit, and other fixed cosu. lt is the amount to be charged to the customer for the work done. If any material, equipment, labor or installations are furnished by the owner, tenant or any other party, the reasonabte market value of such items must be added to the estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, the Ciry may request the submission of a signed copy of the actual contract. MECHANICAL PERMIT APFLICATION AGAEEMENT The undersigned hereby applies to the City for issuance of a Mechanical Pennit, agrees to do all work in strict accordance with the ordinances of the City and the reDulations of the State of Minnesota, and certifies at all statements made on this application are complete, true and correct. Applicant's Signature: Date: �� � Reset Form 3