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PERI�IIT F�CALCULATION(�) <br /> BASED O�F-2002 STATE 3TATUE <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or apvliance that meets all three of the following requirements: <br /> 1. Dces not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludins the cost of the fiacture or appliance: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 /> Totai Permit Fee $ <br /> PEitI.VII'F FEE CALCULATION S -JOBS OVER$�.UO <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Miuimum Fee of$50.00) <br /> � s � � x.0125$ ��,(� �v <br /> contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> I? � D D x.0005 $ �,q � <br /> contract price) <br /> 3. POSTAGE&I�ANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �33��D <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollaz amount chazged for the <br /> permitted work including materials,labor,profit,and other fixed costs. It is the amount to be chazged <br /> to the customer for the work done. If any material,equipment, labor or installations are fiunished 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 PER1v1�T APPLICATIQN AGREEIV�T <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 aze complete, true and <br /> correct. <br /> q� 3 <br /> ApplicanYs Signature: _�(��jj� Date: / ��'� � <br /> 3 <br />