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03-02-'18 13:13 FROM- 1-592 P0003/0004 F-040 <br /> .PERMIT FEE CALCULATION(S) <br /> BASED OFF-2002 STATE STATUE <br /> U Yes,this section applies <br /> The replacement of a Residential fixture or appliance 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;excluding the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip next 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 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$50 00)0 <br /> (g.Gotrpcl pric. mlilljnum Ss01H <br /> 2. STATE SURCHARGE :7. /7/ xgq.L'$) (o <br /> /06 6110)) <br /> rice) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) ($) {�^1;4j1 �;,.7.7. <br /> �;� <br /> �5� <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ -'_ f;. . wM <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 /> MECHANICAL PERMIT APPLICATION 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 /> correct. <br /> Applicant's Signature: )7Y — (P*;) 3-z--/f <br /> J <br /> 3 <br />