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PERMIT FEE GALCULATION(S) <br /> �ASED O��r' -zpo2 STATE STATUE <br /> [f Yes,this section appli�s <br /> 'T'he r�placecnunt vi�a Reside��tial fixture or ap,�liance that me�ts all three of ttie f'ollowing requirements: <br /> ], i]Qes not i•equire modifioation to el�clrical pr�t�s service. <br /> 2, Has a cutal ce�st of'$SQ0.0�or less;excluding the cost of the fixture or applianc4=ttnd <br /> �. Is improved, installed or replae��l by the hpmevwner or l�censed contractor. <br /> Skip ilext sectian,if this applies; Cosc of Permit $ N 5.00 <br /> St�i�Surcharge � S_00 <br /> Mail-In Fde(If Applicable} $ 2.OQ. <br /> `Total!'ermit�'ee $ <br /> 1'L1�Iv1TT��E CALCULATIUN S —JpBS pV�R$500.00 <br /> li�above dueS n�t�lpply; fpllaw guidtllines b41ow: <br /> I, CONTRACT PR10E * is ]?S%ofcontr�act price wikh a(Mi�nimunn �'ee otaS0.U0) <br /> � � ��� `Ox l2S $ <br /> (� ntrtu:l�icc) (u►iuimum$50.U0) <br /> 2. STA7'E SUL�Cl-IARC�, <br /> x.f100� $ <br /> (Cuntrru:l price) ___.__.. <br /> 3. YOS'1'AGL^"&F�iANr7LiNCr (Oniy on Tvlail-1n Applications) $______ 2_00 <br /> �. TOTAL PERMIT F�E(Add Lines l-3 Abov�) $ _ ______ _ <br /> • * GONTRACT PR1GE or JOS COS'1' means ehe actual or estimated dolfsir �unount charged tor the <br /> p4rmitt�d work including ma2erials, labor, profit,aud ofh�r hxed costs. lt is the a�nou�it to be char�4d <br /> to the eustoiner for the worlc dane. 1t'any material, equipmc:nt, labor or installatipns are fut'nished by <br /> the awner, ti�nant or any ocher party, the reasonable market vatue of such items must be added to the <br /> estimated cost or contract price far pennit f'ee pu�oses. In the c:vent khxk Cher� is a dispute on the <br /> amount of the job cosi, thU City may roqu�se th� submission of a signed eopy of the aetual eont�•act. <br /> MEGHANICAL PERMIT APFLIC.ATION AGR.�EMENT <br /> Tt�e undersig��ed hereby applies to the City for issuance o£a Mechanical k'ermit, a�rees to do all <br /> work in strict accordance with the ordina.nces oP the City and Che regulstiuns of the State of <br /> Min�nesata, and certifies tl te ents •de on this applicz�tiun are complet�, true and <br /> correct. <br /> Applica;ni's Signature: Dat�: � � �� <br /> 3 <br />