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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 followin�requirements: <br /> 1. Does not require 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 homeo�vner or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mai]-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> PERIv1IT FEE CALCULATION(S -JOBS OVER $SOC.00 <br /> If above does not apply;fol]ow guidelines below: <br /> 1. CO\'TRA�T PRICE * is 1.2�%of contract price with a(Minimum Fee of�50.00) <br /> LoJ�C` �C��C' x .0125 $ �`J -�5 <br /> (concrsct pnce) (minimum�50.00) <br /> 2. STATE SI:RCHARGE <br /> �c3 C���.r C X.000s � 3 : 1 s <br /> (contract price) <br /> 3. POSTAGE&HANDLP.�IG(On?y on NSail-In Applications) $ 2.00 <br /> 4. TOTAL PERNIIT FEE(Add Lines 1-3 Above) $ O� �j C' <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount chareed for the <br /> permitted work including materials, labor,profit, and other fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material, 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 /> estimated cost or contract price for permit fee purposes. In 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 appli to the City for issuance of a Mechanical Permit, aQrees to do all <br /> work in strict accordance wit the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statements made on this a plication are complete, true and <br /> correct. <br /> � ' <br /> Applicant's Signature: � �Date: �7 �� �J <br /> i, <br /> Reset For��� <br /> 3 <br />