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y9529331869 13:36:54 03-12-2015 3/3 < PERMIT FEE CALCULr�#TION(S) BASED OEF-2002 STATE-STATUE ` ❑ Yes,this section applies The replacement of a Residential fixtwe or ap�liance that meets all three of the following requirements: 1. Does not require modification to electricai or gas service. 2. Has a t 1 cost of$500.00 or less;excludine 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 $ 15.00 State 5urcharge $ 5.o0 Mail-In Fee(If Applicable) $ 2.0 Total Permit Fee $ PERMIT FEE CALCULATION S -JOBS OVER'$500.00 If above does noi apply;follow guidelines below: 1. CONTRA.CT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) (�2�JVIJ•W x.0125$ �Q.Vt1 (contract pricc) (min3mum$50.00) 2. STATE SURCHARGE �Z� 'rJ�•Q7 x.0005 I•Z {contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines I-3 Above) $� S!. Z.�j ■ * CONTRACI' 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. Tf any material,eyuipment,labor or installations are furnished by the owner,tenant or any other party,the reasonabfe mazket value of such items must be added to the estimated cost or contract price for permit fee purposes. Tn the event that there is a dispute on the amount of the job cost, the Ciry may request the submission of a signed copy of the actuai contract. 1VIECHAIVICAL PERIVIIT 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 Mi�uiesota, and certifies that all statements made on this application are complete, true and correct. Applicant's Signatur : a- C G!� Date: � �2 �S 3