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Jun 15 15 03:12p Legend Services Inc 763-479-6003 p.4 <br /> � . <br /> PERMI'f F£�CALCL�LATION(S) <br /> j BASED OFF-2002 STATE STATUE <br /> [�; Yes,this section appiies <br /> 'I'he repiacement of a Residential fixture or appliance that meets all three of the foliowing requirements: <br /> 1. Does not require modification to electricai 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. ls improved,instatEed or replaced by the homcowncr or licensed contractor. <br /> Skip next section, if this applies; Cost of Permit $ E 5.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> PERMIT FEE CALCULATION S)—JOBS OWER$500.00 <br /> If above does not apply;fallow guidelines below: <br /> l. CONTRACT PRICE * is 1.25%of contract price with a{Atinimum Fee of$SO.UI?) <br /> � `�SO �.a�2s $ �a, vo <br /> (cantract pricc) (minimum SS0.00) <br /> 2. STATE SURCF[AIiGE y�!l <br /> V x.00QS $ • �� <br /> (contract pnce) <br /> 3. POST.AGE&HANDLING(Only on Mail-ln Applications) $ 2.�0 <br /> �� <br /> 4. TOTA1,PERMITFF,F,(Add I,ines 1-3 Above) $ �a� <br /> � * CONTRACT PR[CE or JOB COST means the actual or estimated dollar amount cha bed for the <br /> permitted work incliiding rnater�als,labor,profit,and other fixed costs. It is the amount to be charaed <br /> to the customer for the work done. If any material, equipment,labor or installations ace furnished by <br /> the owner, tenant or any other party,tF�e reasonable market value of such items m�st be added to ihe <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 Ciry may requesi the submission of a signed copy of the actuat contract. <br /> Iv�ECHANICAL PERMIT APPLiCATION AGREEMENT <br /> The undersigned hereby appiies 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 slalem��ts made on tliis application are complete, t►-ue and <br /> correct. <br /> Applicant's 5ignature: �� ��cr�d+�'-G( Date: �P ���'�� <br /> 3 <br />