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, <br /> �� �� ���ERMIT FEE CALCUI,ATION�S) � �� �� � <br /> BASED QFF - 2002 STATE�STATUE <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> l. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludin�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 CALCi.JLATIClN S)-JOBS C}VER$504.00 <br /> If above does not apply; follow guidelines below: <br /> 1. CONTRACT PR[CE * is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> 3 �D���v X.o��s $ �'��d <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> ��OU (,�O x.0005 $ I, �� <br /> (wntract price) <br /> 3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 5 �*� � <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> per►nitted work including materials, labor,profit, and other fixed costs. lt 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 uf a signed copy of the actual contract. <br /> MECHANIGAL PERMIT A;PPLICATION 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 /> � <br /> ApplicanYs Signature: L%(.�c.�'i �a'1'i�'�~� Date: �'—l �� �Y <br /> Reset Form <br /> 3 <br />