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9529331869 21_03:19 02 17 2015 4/4 <br /> PERMIT F.EE CALGULATION(S) , <br /> BASED OFF-2002 STATE STATUE <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or a{Zpliance that meets all three of the following requirements; <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a total co�t of$540.00 or less;exciudine the cost of the fixture or appliance:and <br /> 3. Ts improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.Q0 <br /> State Surcharge $ 5.00 <br /> Maii-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> PERMIT;FEE CALCULATION S -JOBS OVER:$SOO.QO <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRAC'I'PRICE *is 1.25%of contract price with a(Minimum Fee of$SO.QO) <br /> ���,Q�.Q� x.0225$ 2�2.� <br /> (coniract price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> � t�q�d.00 X.000s $ 8.so <br /> (contract price} <br /> 3. POSTAGE&HANDLING(Oniy on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 22�.� <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. 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 /> Iv1ECHAIVICAL PERIVIIT APPLICATION A.GREEMENT <br /> The undersigned hereby applies to the City for issuance of a Mechanica! Permit,agrees to do all <br /> work in strict accordance with the ordinances of the City and the regutations of tlie State of <br /> Minnesota, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: l. Date: �Z �� ZQf� <br /> 3 <br />