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-ap, s '1 <br /> x Nd T 'K,uMy}._.-�+' <br /> "„,, „`.k. . <br /> 1. CONTRACT PRICE * is 1.25%of contractpricewith a(Minimum Fe f$50.00) <br /> ant0 5 ( x.0125$ �C)IQ() <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE9k1 5- l <br /> � x.0005 $ ' ((al <br /> (contract price) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) S 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 5 3'413 <br /> • * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor,profit, and other fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material,equipment,labor or installations are furnished by the <br /> owner, tenant or any other party, the reasonable market value of such items must be added to the <br /> estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the amount <br /> of the job cost, the City may request the submission of a signed copy of the actual contract. <br /> .S '.R1n!~+]'} , .~ tl«. es r'M ' D 77741 <br /> D741,:).:00:104a04'47. <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota,and certifies that all st.tements made on this application are complete,true and correct. <br /> Applicant's Signature: 4014,7 � Date: faP <br /> ' <br /> 3 <br />