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� P <br /> PERMIT FEE CALCULATION(S) <br /> BASED OFF -2002 STATE STATUE <br /> ❑ Yes,this section applies <br /> The rcplacement oC a Residential fixt�ire or appliance that meets all three of tl�e following requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excltidin�the cost of the fixhire 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 Pennit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> � PERiv1IT FEE CALCULATION(S)-JOBS OVER$�00.00 <br /> If above does not apply; follow guiclelines below: <br /> L CONTI2ACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> � I���.L�'� x.0125 � �' �T� <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCIIARGE , � <br /> � � �� x.0005 $ . �`7 <br /> (contract price) <br /> 3. POSTAGE& HANDLWC(Only on Mail-ln Applications) $ 2.00 <br /> —7 � <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � � (`7 <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> pennitted work inclucling materials, labor, profit, and other fixed costs. h is the amoimt to be charged <br /> to the customer for the work done. lf any material, equipment, labor or installations are furnished by <br /> the o�vner, tenant or any otl�er party, the reasonable market valt�e of sucl� items must be added to tl�e <br /> estimated cost or contract price for pennit fee purposes. ln 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 /> MECHANICAL PERMIT APPLICATION AGREEMENT <br /> The undersigned hereby applies to the City for issiiance of a Mechanical Permit, agrees to do all <br /> work in strict accardance 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 /> A licant's Si nature: ��-�'L � -G Dat : L� <br /> pp g � e !U r.�Ul <br /> 3 <br />