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� � <br /> � R <br /> PERMIT FEE CALCULATI�N{S) <br /> BASED OFF-2Q02 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 rec�uire 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 $ 5.00 <br /> Mail-In Fee(If Applicable} $ 2.00 <br /> Totai Permit�'ee $ <br /> PE�+fI'f F���CALCUi.A1`�QN(S�-.fUB��3�ER$Sat3.0U <br /> If abovc does not apply:lollow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25 io of contract price with a(Minimwn Fee of$50.00) <br /> �� x .0125 $ �', 1.�� <br /> (contract price) (m�nimum$�0.00) <br /> ?. STATE SUKCHARGE �C�`�� <br /> x .0005 $�_V <br /> (conVact p�ice) <br /> 3. POSTAGE& HANDLING{Only on Mail-In Applications) $ 2.00 <br /> 4. 'COTAL PERMII'FEE(Add Lines 1-3 Above) $ ��•O� <br /> ■ " CONTRACI' PRICF or JOB COST means the actual or estimated dollar amount charged for the <br /> pern�itted work including materials, labor,profit, and o�her fixed costs. It is the amount to be charged <br /> tu �he custumer for Che work do��c. IC any material, equipment, labor or installations are lurnished by <br /> the owncr, tcnant or any othcr party, Lhe rcasonable market value of such items musl bc addcd to thc <br /> estimated cost or contract price for permit fee purposes. In the evcnl that there is a dispwe on the <br /> amount of thc job cosL the City may reyuest the submission of a signed copy of tl�e actual contract. <br /> ME�HARFIGAL PERMIT APPLICAT1tJN AGREEMENT <br /> Th� undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> work in strict accordance with the ordinances of the City and the regulationti of the State of <br /> Minnesuta, and certifies that all statements made on this application are coinplete, true an� <br /> correct. � <br /> Applicant's Signature� _ _ Date: __)�I��t�_ <br /> Reset Form <br /> 3 <br />