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��d��'r. PERMIT FEE CALCULATION(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 seivice. <br /> 2. Has a total cost of$500.00 or less;excludine the co$t of the fixture or appliance:and <br /> 3. Is improved, installed or replaced by the homeownet or licensed contractor. <br /> Skip next section, if this applies; Cost of Permit $ 15.00 <br /> State Surch�rge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> 'fotal Pert�tit Fee $ <br /> � � ' �+���� � �„� � �� � r��� <br /> ..�;� , ..� . <br /> �° �'ERMTT F� � r R... 4�;{� ,.��A����°-�� ���. <br /> , <br /> . , , <br /> ' - - �� , ,. .,, <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 /> . ' ��C/V. Pl/ x .0125 $ /O((J� 0�.7 <br /> (contract pricc) (minimum$50.00) <br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee ofS5.00) <br /> ✓4C/, 'v ' x.0005 $ �./• � <br /> (contract pricc) (minimum$5.00) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines I-3 Above) $ / 3.�7'� <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 fi�ced costs. It is the amount to be charged <br /> to the customer for the work done. If any material, equipme�t, labor or installations are fumished 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. Ir� the event that there is a dispute on the <br /> amount of the jab cost, ihe i,iry rnay reyuest the sucn.ission of a signe6 cupy of tne actual contract. <br /> • **The STATE SURCHARGE is .0005 times the Contract Prr.ce or a minimum of$5.00. <br /> ' • � , MECHANICAL PERMIT APPLICATI�N AGREENIEN� rfs'; .�� ... <br /> The undersigned hereby applies to the City for issuance of� 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 thi5 application are complete, true and <br /> correct. <br /> Applicant's Signature: ' Date: r���� <br /> Reset Form 3 <br />