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. <br /> ` PERMIT FEE CALCULATIQN(S) <br /> BASED OFF-2002 STATE STATUE <br /> ❑ Yes,this section applies <br /> The replacement of a Residenrial fixture or ap,�ance that meets all three of the following requirements: <br /> 1. Dces not requiee modification to eleetric�l or gas service. <br /> 2. Has a�of$500.�or less;elccluding the cost of the fixture or appliance:and <br /> 3. Ls improved,insta(led or replaced by the homeowner or licettsed contxactor. <br /> Skip next section,if this appli�; Cost of Permit $ 1 S.QO <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit F� $ <br /> PERMIT�EE CALCULATIt�N S -JOB5 OVER$500.04 <br /> If above does not apply;follow guidelin�below: <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimam F�of$50.00) <br /> �l�� x.0125$ �"�•O�j <br /> (contract price) (miaimam$50.�) <br /> 2. STATE SURCHARGE ��,��0 x.0�5 $ 3•O� <br /> (comract Pr►ce) <br /> 3. POSTAGE&HANDLIAiG(Qnly on Mail-In Applic�tions) $ 2.00 <br /> 4. TOTAL PERNIIT FEE(Add Lines 1-3 Above) $ �.�� <br /> • * CONTRACT PRICE or JOB COST means the actual or estimated dollaz amount char�ed for the <br /> pemutted work including materials,labor,profit,and other fixed costs. It is the amoum to be charg� <br /> to the customer for the work done. If any material, equipment,labor or installations are fumished by <br /> the owner,tenant or any o�►er party,the r�sonable market value of such items must be added to the <br /> estimated cost or contract price for permit f�purposes. In the evem 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 actuat contract. <br /> MECHANICAL PERMIT APPLICATION AGREEMENT <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agees 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 /> coire,ct <br /> ApplicanYs Signature: �''�/(� y'���„ Date: �� Gj� � � <br /> —�„— <br /> 3 <br />