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. <br /> ! <br /> PERMIT FEE CALCULATI0�1(Sl <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$�00.00 or less;excludinQ the cost of the fixture or appliance: and <br /> �. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip neYt section,if this applies; Cost of Permit $ 1�.00 <br /> State Surcharge $ �.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> i PERMIT FEE C ALCIJLATION(S)—JOBS OVER$SOC.00 <br /> If above does not apply;follow guidelines below: <br /> 1. CONTR4�T PRICE * is 1.��%of contract price with a(Minimum Fee of��0.00) <br /> 3°�G��D� X .oi2s� Sv • od <br /> (cont;act pnce) (minimum 5�0.00) <br /> 2. STATE SL'RCH�RGE <br /> � l� , a�.000� � �. 9� <br /> (co�ct price) <br /> �. POSTAGE R HA\TDLI'.�IG(On!y on A�1ail-In Applicationsl $ �.00 <br /> .� <br /> 4. TOTAL PERNIIT FEE(Add Lines 1-3 Above) � . <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount cha;Qed for the <br /> perrnitted work inclsding materiais, labor,profit, and other fixed costs. It is the amount to be chartred <br /> to the customer for the work done. If any ma±erial, 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 /> es:imated cost er contract price for perrnit fee purposes. In the event that the;e is a dispute on the <br /> amount of:he job cost, the City may request the submission of a si�ned copy of the actual contract. <br /> MECHANICAL PERl�1IT APPLICATION AGREE�LENT <br /> The undersi�ned hereby applies to the City for issuance of a Mechanical Permit, a�rees to do all <br /> work in strict accordance with the ordinances of the City aad the regulations of the State of <br /> Minnesota, and cenifies that all statements made on this application are complete, true and <br /> correct. <br /> Applicant's Si�nature: Date: � �Q/ <br /> Reset Form <br /> 3 <br />