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Apr 26 13 11:54a Twin City Fireplace 9529422093 p,3 <br /> i ; PERMIT�`EE CALCULATI�N(S) <br /> ' BASED OFF-2002 STATE STATUE <br /> �] Yes,this section applies <br /> The replacement of a Residential fixture or aaa(iance that meets all three of the following requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a totnl cost of$500.00 or less;exciudin�the cost of the fixture or appliarece:and <br /> 3. ls improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip ne�ct section,if this applies; Cost of Permit $ 7 g,pp <br /> State Surcharge $ S.pp <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Perr�it Fee � <br /> PERIV�T FEE CAT,CULATION(S)—JOBS OV�R$504 00 <br /> If above does not apply;follow guidelines below: <br /> l. COVTR.4CT PRICE * is 1.25%ofcontract price with a(Minimum Fee of$5p.00) <br /> �q(��— X.o�2s$ � ,rJ� <br /> (contrac[price) (minimum550.00) � <br /> 2. S'I'ATE SURCHARGE <br /> _� G( ��" x.000s s � ��a <br /> '(contract price) <br /> 3. POSTAG�&I�f.qNDLING(Qnly on wtail-In Applications) $ 2.�p <br /> 4. TQTAL PER1�lIT FEE(Add Lines 1-3 Abovej $ �� . "J� <br /> • * CONTRACT PRfCE or JOB COST means Ehe actual or estimated doUar amount charged for the <br /> permitted work including materials, [abor,profit,and other fixed costs. It is the amount to be charged <br /> to the cUstomer for the work done. if any material, equipme�t, labor or installations are furnishad by <br /> the owner,tenant or any other party,the reasonable market value of such items must be addec�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 requesi the submission of a signed copy of the actual contract. <br /> MECHANICAL PEKMIT APPLICATIOh�AGREEMENT <br /> The undersigned hereby applies ta the City for issuance of a Mechanica] Permit, agrees to do aI� <br /> work in strict accordance w•ith the ordinances of the City and the reguIations of the Siate of <br /> Minnesota, and certifies that all statements made on this application are complete, true and <br /> correc� <br /> Applicani's Signature: QFt na�: 'y�y I z <br /> -I�-�--- <br /> 3 <br />