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. PERMIT FEE CALCUL TIONS) 2002 State Statute ❑ Yes his Section Applies The replacement of a Residential fixt> e or applianc'fhat meets all three of the following requirements: 1) Does not require modificat m;to electrical or gas service. 2) Has a total cost of$501.10 or s; excluding the cost of the fixture or appliance: and 3) Is improved, i . ailed or replaced by the ••meowner or licensed contractor. Skip - section; Cost of Permit $ 15.00 • State Surcharge $ .50 Mail-In Fee $ 1.50 If above does not apply, follow guidelines below: 1. Contract Price* is .0125% of job with a Minimum Fee of($35.00) c?6,DS(5 x .0125 $ 2 �s ( , oLc, (contract price) (minimum$35.00) 2. State Surcharge. ** Add the State Building Code Division a Minimum Fee of($ .50) (4Ce,o&'S x .0005 $ 12. (contract price) (minimum$.50) 3. Postage and Handling(Only mail-in applications) $ 1.50 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ 5 50.( z J *CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including materials,labor,profit,and other fixed costs. It is the amount to be charged to the customer for the work done.If any material, equipment,labor,or installation is furnished by the owner,tenant or any other party the reasonable market value of such items must be added to the estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost,the City may request the submission of a signed copy of the actual contract. **The STATE SURCHARGE is.0005 of the contract price under$1,000,000 or$.50-whichever is greater.For valuations over $1,000,000 call the Department of Inspectional Services for the price. The undersigned hereby applies to the City for issuance of a Mechanical Permit,agrees to do all work in strict accordance with the ordinances of the City and the regulations of the Minnesota State Building Code,and certifies that all statements made on this application are complete,true and correct. Applicant's Signature: ' -�...�- t� 9 Date: Approved By: est Date: 2 'Z 3