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952933?.869 21:00:16 12-08-2014 4/4 <br /> PERMIT FEE CALCULATION(S) <br /> BASED OFF:-2002 STATE STATUE ' <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or agpliance 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;exclu in the cost of the fixture or appiiance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip ne.ct 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 /> : PERMIT FEE CALCULATIUN S —JOBS'CfVER$500:00 <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE * is 1,25%of contract price with a(Minimum Fec of$50.00) <br /> � 2,500.00 x.oi2s$ � 50.00 <br /> (contract pricc) (minimum$SQ.00) <br /> 2. STATE SURCHAI2GE d� <br /> `� �-,���Q� x.0005 $ � �.Z� <br /> (contract pricc) <br /> 3. POSTAGE&HANDLING(On}y on Mail-In Applications) $ 2.00� _ <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � 'r'J f.2.� <br /> ■ '" CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor,profit,and other fixed costs. Tt is the amount to be charged <br /> to the customer for khe work done. If any material, equipment, labor or installations are fumished by <br /> the owner, tenant or any other party, the reasonable rnarket value of such items must be added to the <br /> estimated cost or contract price for permit fee purposes. In the event diat there is a dispute on the <br /> amount of d�e job cost, the City may request the submission of a signed copy of the actual contract. <br /> ; NIECHANTCAL'PERIVIIT APPLICATION A.GREEMENT <br /> The 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 tlae City and the regulaeions of the State of <br /> Minnesota, and certifies that alI statenients made on this applicatio�i are complete, true and <br /> correct. <br /> Applicant's Signature: ��i2� �N� Date: �2 08 1`� <br /> � <br /> 3 <br />