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� .•., <br /> . . <br /> i PE�I�IIT FEE Cr�LCU��TIO�(S}. _� <br /> ' B.�,SED t�FF- 2��1? ST:�TE ST�TL�E <br /> ❑ Yes,this section applies <br /> "I"he re�lacenient of a Kesideiitial�xYure flr,a��liai�ce tl�at�xaeets all thre�rat tlze folla�n�ia��rec�uir��nc:nts� <br /> 1_ Da�s ixot r�c�riire inoziificatian tn�lectrical or�as service. <br /> 2. Ha�a tatal cost of$�OOAQ or le�s:excltiding the co�t ot�t�ie�ixt�u-e or appliance:ancl <br /> 3. Is unpro��ed,itLstalled or replaced t�y the honieo�,7��i•or lic�iised contractor. <br /> Skip�r�xfi�ecti�i�,if tlus a�plies; C'ost nf Pe��x���it ��15.00 <br /> State Surchar�e � i.{?fl <br /> _ �_..�._.._........_....... <br /> �+vZail-In F'�e(I�'r'�pplic�ble) � 2m(l0, <br /> Tntat Pern�it Fee �a� <br /> _ _.__ _._ <br /> ���:�t�r���.���t���r��ar��s� ;; �������.��rio:oo ; �1 <br /> If ab�ve d�efi uoi appiyz followr�uid�liz�es beiow: <br /> 1. Cl7�TKt�CT PRICE *is 1.25°la af cai�tract�rice t�•ith a(Minimum Fee of$SO.UO} <br /> �C �' �'� <br /> � �� ���......... ......... . x.fl 125� -_.r.._. �___......�_ <br /> (crnztra�t price) (mtn�mnna�S50.40) <br /> 2. STATE SURCHARGE <br /> x.00QS S <br /> (contract prica) <br /> 3. POS'i'AGE�z HA.NDLIIvG E�nly on Mail-In Applicarions} � �.C10 <br /> 4. TOTAL PERMIT FEE(Acicf Luies I-3 Abot-e) $ <br /> _ * CONTR+��T PRIGE or 1O8 CE7ST zneaz�.s tlie aetua3 c�r estisnated dnIlar aniotuit eliarged fc�r t�ie <br /> p�ni�itted���ork uic2uduig n�ateiials.labor,praf€,az�d other fiset�eosis. It is tl�e a�ucr«nt to be eharged <br /> ta the c�ist�mer for the wark dane. If s�riy z�saterial, eqaip�7i�nt.lat�or c���znstailatiaits are�urxtzshed by <br /> tlie owiier, t�r�aut or aziy other party, tlie reasoxiat�le market c•alue of such iterns rtiust b€ a�ldec�to th� <br /> estunaferl cost ar contract price for pzi�tnit fee piu-�wses. In tlie et��ut that there is a di�ptrte or� the <br /> amoucit of�tl�i�jot� cost, the City� may request tixe subtnis�ion c�f a �i�neci copy of t[�� actual eoi�tract. <br /> � � ,:�. ;;- <br /> IvI�CH�.i�TIC't1I�P� _ :; �!�.. �� , �� t�E1�TT `: �_'F ,..;- . <br /> The �uicier�i�ried t�ercby applies t� the City fur iss�<<uice of a Mec1l�t�ical Peiuiit, a�rees tc� d� alI <br /> work izi sxrict accard�utce va�itli tlt� ordii�ances of t11e City and tl�e re�ulations af the State of <br /> �fiirui�sota, and cer�i�ies 11at a si�iet�i �ts ma e on ihis apF�lication are complete, true a�ld <br /> GQT'i'�CT. <br /> E���JIICIIIT's Si�nature: Date: ��'/� <br /> . ) <br /> � <br />