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Nov 1716 02:38p Twin City Fireplace 9529422093 p.3 <br /> • ' �- � <br /> I <br /> PERMIT k'EE CALCULEITION(S) <br /> - BASED OFF-2002.STATE STATUE <br /> ❑ Yes,this section applies <br /> 7`�e lacement Qf a Residcntial fixture or apptiance that meets all three of the following requirernents: <br /> 1. not require modificatian to electrical or gas service. <br /> 2. Has a total cost ofS500.00 or less;excluding the cost oftf►e 6xture or appliance:and <br /> 3. is impraved,insta(!ed or roplaced by the homeowner or licensad contractor. <br /> 3kip next section,if ihis applies; Cost of Permit S 15.Q0 <br /> s�s�t� s s.oa <br /> Mail-In Fee(If Appiicable) S �.OU <br /> Total Permit Fee S <br /> PERMIT`FEE CALCUI.ATIOlV S --)OBS OVER$SOO.QO- <br /> If e does not apply;follow guidelines below: <br /> l. CO1�iTRACI'PRICE *is 125%of contract pcicc with a(Minimam 6ee of$50.00) <br /> '��..� �.�� x.0125$ ��_ <br /> (contract price) (mirimum S50.oD) <br /> 2. STA,T�SURCHARGE <br /> ��' D �'� x.0005 ST ,� � , <br /> (contract price) <br /> 3. I'OST,�IGE&HANDL[NG(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAFI.PERMiT FEE(Add Lines t-3 Above) S �'J�� <br /> • * ONTRA PRICE or JOB COST means die actval or estimated doftar amount chazged for the <br /> itted wor including materials,labor,profit,and other fixed costs. It is the amoant to be charged <br /> to custom for the work done. If any material,equipment,labor ar inshallations are fumis[�ed by <br /> th owner,ten nt or any other party,the reasonable market value of such items must be added to the <br /> rnated cost�or contract price for penrut fee purposes. In the event that there is a dispute on tt►e <br /> unt of the job cost,the Ciry may nequest the submission of a signed copy of the actual contract <br /> 1WIECHANICAL PERM�'f APPLICATION AGREEMENT <br /> The u ersigned hereby applies to the City for issvance of a Mechanical Perroit, agrees to do a]1 <br /> work ' strict ac¢ordance witfi the ordinances of the City and �e regulations of the State of <br /> Minne ta, and certifies that all statements made on this application are complete, true and <br /> corsect <br /> Appli ' t's Signature: Date: 1:1,J l l� <br /> - - y <br /> 3 <br /> I <br />