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04-12-'18 12:46 FROM- 1-784 P0003/0004 F-261 PERMIT FEE CALCULATION(S) BASED OFF-2002 STATE STATUE ❑ Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: I. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less;slin the cost of the fixture or appliance:and 3. Is improved,installed or replaced by the homeowner or licensed contractor, Skip next section,if this applies; Cost of Permit S 15.00 State Surcharge S 540 Mail-In Pee(If Applicable) $, 2,00, Total Permit Fee S PERMIT FEE CALCULATIONS) JOBS OVER$500,00 If above does not apply;follow guidelines below: I. CONTRACT PR1C& bis 1.25%of con met price with a(Minimum Fee of pm) < -.� —;� 6jurig rM WO' nlgrif PAppJ)'_ 2. STATE SURCHARGE 38 Ofa x�:OQO w) l� l 1 VihagINIV 3. POSTAGE&HANDLING(Only on Mail-in Applications) h1 4. TOTAL PERMIT PEE(Add Lines 1-3 Above) .. ;• ■ " 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 installations are 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, MECHANICAL PERMIT APPLICATION AGREEMENT 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 State of Minnesota, and certifies that all statements trade on this application are complete , true and correct. a Applicant's Signature: _ ' (13iTti Li"--2A e 3