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� 95293�1869 11:52:25 07-13-2015 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 appliance that meets all three of the follo�ving requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;exeludin�the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the horr�eowner or licensed eontractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) ,e, 2.00 <br /> Total permi#Fee $ <br /> PERMIT FEE CALCULATION S --JOBS OVER$500.00 <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$SOAO) <br /> �2,50U•0(a X.oias$ 50.0� <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> �Z,��•� x.00OS $ I.Z5 <br /> (contrac�price) <br /> 3. POSTAGE&HANDLING(On[y on Mail-In Applications) $_ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �.Z—rj <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. Iti 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 /> 1VIECHANICAL PERMIT AAPLICATION AGREEMENT <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 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 /> cocrect. <br /> A licant's Si nature: ��� <br /> rr � �zt�: i� 1� 1�' <br /> 3 <br />