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01/27/2011 11:38 FAX 7634795002 LEGEND SERVICES I�009 <br /> PERMIT FEE CALCULATION(S) <br /> BASED OFF -2002 STATE STATUE <br /> ❑ Yas,this section applies <br /> The replacement of Q ge,�eDllEel 1lxturfl or appliance that meets all three of the following�equi�'ements: <br /> 1. Does not require modific:aHon to electrical or gas service. <br /> 2. Has a t r�l cost uf SSOD.OD or less;excJ�the cost of the frxtnre o�a{�pliance:and <br /> 3. ls itnproved,ii►stalled or replHccd by tt�e bomeowner or licensed co�tractor. <br /> Skip next section,if this applies; Cosl of P�rmit � 15.00 <br /> State Surcharge $ 5.00 <br /> Meil-In Fee(If Applicuble) $ 2,pp <br /> I, Total Pcrmit Fee � 22.00 <br /> PF,RM[T FEE CALCULATION S —JO,BS OVER$500.00 <br /> IFabove does not apply;follow guidelines be►pw; <br /> 1, CONTRACT P'RyC:E �is 1.25%ofcontract price with a(Minlmum Fee of$,40.Ot1) <br /> 1 �a:�'�� �r� <br /> x ,0125$ �— �/* � <br /> (cuAlUucf pCice) (miuimum ST�U.QO) <br /> 2. 5TA'fE SUltl,�' ) R(:F: �K Add the State B(dg Code Div_Surcharge(Minimum Fee of$5.00) <br /> .a2.00 <br /> x.ODUS $.5.00 <br /> .._..............__ <br /> (coalrac[price) (minimum 8 s.00) <br /> 3. PpSTAGE&IiANDL1NG(Only on Mail-In Applicatiqns) � z.qU <br /> � '�5� <br /> 4. 'I'U'1' � PGRMIT CEE(Add Lines 1-3 nbove) $��� �� <br /> " * CONTRA PR10E or JOS COST' means the actual or estimatad dollar amount charged for the <br /> permitted work ii�cluding materisly,lub�r,profit,and other fixed costs. lt is the amount co be eharged <br /> to the custom f'or the work done. If any mal.erial, ccjuipmenl,labor or instellations are furnished by <br /> the owner,ten t or xny other party,the reasoiiable market value of sucti items must bC added Iai !h� <br /> ostimated cost r con.tract pricz for pormit fve purposes. In tbe event [hat iherz is a disput� un the <br /> amount of the ob cost, i.ho City may request the submission of a signed copy of the ectua! contrsc� <br /> ■ *'"The STATE�SURCNARGE is ADOS times fl�e Conit�lu6 Pricc or a minimum nf$5.00. <br /> � <br /> M�,CI-�ANICAL PERMIT Al'PLICATION AGRFr�VTENT <br /> The under�ibn�d hcreby applies to the City for issuance oF a Mechanical Permit, agrees to do all <br /> work in scrict accordance with the ordinanccs af the Gity and the regulations of the State of <br /> � Minnesota, and certifies that all statements made on this applicRtion are complete, true v�d <br /> correct. <br /> � Applicant's Signature: � <br /> ���r, nate; ���7��� <br /> 1 <br /> Reset Form 3 <br />