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r <br /> � � � � PERMIT FEE CALCULf1T10N(S) � <br /> � � - BASED OFF -�?002 ST�1TE STATUE � � � �� � <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or a�pliance 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$500.00 or less;excludin�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 /> Total Permit Fee $ <br /> P�RMIT�EE'CALCULAT��}�T �}',-�CJBS C7VER$SOO,UC} � �` .',, �,.' <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$50.00) <br /> I / <br /> c1 � SC�. ��X) X.oias$ ��� � �� <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE � ,., ` <br /> � , ��-�� C�i x.0005 $ �� � � <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ `, ` <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitCed 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 /> ��� �..... '���-� MECHAI�iI��L PERM�, ,�1'�LI �'� (��AGR���rI���' ... '��� <br /> ;;: �� <br /> The undersigned hereby applies to the City for issuance 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 /> i <br /> Applicant's Signature: �"�'�UG' i� ' i Date: � � � �� <br /> �_ <br /> ������ �Reset Fo�rn � <br /> 3 <br />