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PERMtT EEE CALCllLA'�'I�l'�ti��} <br /> BASED OFF -2d02 5'1'A ' AT'�TE <br /> � 1'as,this s�ction applies <br /> fihr repl�ceinent ot a Residential fi�turc or appliazice that mests�11 dhree trfth�f`c�ll�wine requirem�nts: <br /> 1. Uaes not rzquire modificatiim to elec�trical�)r gas sen:ice. <br /> _. I�as a total cost of�S�OG.qO ar less;e+�cludine the cost of�th��xture or appliance.and <br /> :. (s im�rc���ed_installed Qr repl�e�cl by the hc�n�eo�vner c�r lic�nsed contractor. <br /> Skip ne�t secti�>n, if this ap}�li�s; C�st i�f Permit � (�.0� <br /> 5t�te Surcharae 5 �.00! <br /> '�tail-In Fee i If.Applicabie) � 2.00 <br /> Total Permit Fee S <br /> PERA�I7"'�'��Caa�►►�., , �'�`ItJ►N(S}—JUBS OVER SSOO.t�1 ` <br /> lf�ab��ve cloes nvt ap�l}�:fc�llow�uidrlines bclow�. <br /> i. C'O!'[�RA(:"'1�PRICE * is 1.?5fl�o of�;��ntraci�riee�iith a('Viinimum Eee of��+U.00) <br /> Z.E'lOC7� x.O12�5 ,�•Ot� <br /> ...._._ <br /> {�nntract prace! {mm�mum 5.�17.00) <br /> ?. ST,�TE SCRCIf.1RGE: <br /> �'t7� x.t�(�05 S 1.�l l) <br /> (:att�5r.t nt:tC3 —�.- --- --- —�-- <br /> �,. PUSTAGG c� H.4�Dl.l\C:�{C)nly c�n ,Rtail-In ��pplic�uons) � 2.�0 _- ---- <br /> �. �1�t1TAL PER�11T F6E t,4dd Lines 1-�� �1bc�vc! S <br /> • '" CO�'rTR.�C'T flR[CE ar JOB CCiS7° means the actuat or estimacrd d<711ar amount charged for the <br /> permitted ��orl. includina: rnaterials.labe�r, prot'it.and other fixed costs. It is the amount to be ehar�ed <br /> to the customzr t��r�he c�ark done. If�ny m�terial, equipment. labor or installations are furnisl�ed b� <br /> the owner, tenant r�r an}' ��ther p�rt;�, the rea5onable market value i�f such items must tae added tc�the <br /> estimated cost or runtract �rice f�r �ermit fee pur{�i�ses. In the event that there is a dispuie nn the <br /> amaunt of the,�ub 4u�t. tl�� City� 1nay� request the submission uf a siened cop�� �f th� actual ce�r�tr�ct. <br /> [� MEGHAN[CAL PERMI't"APPLI�AT�t�N�1GRE��k+1�NT > <br /> �'�i�e undersi�tnacl k�ereb} a�pli�s tc� the Citti for issuanee c�f a Mechasiical Perinit, a�rees to da all <br /> +�t�rk �n striet accor�iance ���ith the ordinances of the Cit� ar�d �he re�ulatic�ns of the State of <br /> !��9i�nnesota, ai�d certities that all statements made e�r� tl�is �pplicatic�t7 are c�rnpletr, true and <br /> corre�t. <br /> l <br /> ,Applitant's �i�nature: � � Date: ����1�� <br /> �. _ _._ . _.. ._---- _--_ <br /> - -- —___ ... <br /> ,� <br /> � � <br /> �t,; <br /> �� 3 <br />