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JUN/20/2016/MON 08:53 AM Heating & Cooling 2 FAX No, 7634283677 P, 004
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<br /> � Y'es,this section applies
<br /> Ths replacxn�ent of a Ra i 'al r a lience that meets all three o�'th�following requiresnents:
<br /> 1, boes not require modification to el�trical vr gas service.
<br /> 2. Has a total cost of$500.00 or l�ss;exeludine�e oost of the fixiure or appliance:and
<br /> 3. Is improve.�,i.nstalled o�r rtplaced by the homeowner or licensed contract�r.
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<br /> Skip next section,if this applies; Cost of Permit � 15.00
<br /> Scats 5urchsrge $ 5.00
<br /> Mail-In Fee(If Applicablt) $,, 2 90
<br /> 'T'otal Permit Ree S
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<br /> If above does not apply;follow guidelines bolow;
<br /> 1. CONTRACT PRYCE * is I.25%of contract prico wi'c1��(Minimam Fce oi$SU.00)
<br /> � � �� /.._ x.0125$
<br /> (coutreat price) (aoinimam 550.00)
<br /> 2, STAT�S�7YtCHAYtGE
<br /> x.000s � .
<br /> (Contreatpdce) ---
<br /> 3. P�STAG�&HANALING(Only on Mail-In Applications) $ 2.0�
<br /> 4. TOTA,L��R1vx�T k'E�(Add Lines 1-3 Above) . $
<br /> ■ * CONTR.ACT P�C� or rOB COST moans tho actual or estimated do)1.ar anaount char�ed for the
<br /> permitted work ineluds�g materials,labor,profit,and otl�er fixed costs. Tt is the aanount to be charged
<br /> tp the customer for the work done. If any material, equipment, labor or installarions�e fiusxished by
<br /> the owner,tenant or any o�her party,the reasonable marlcet value of such items mnst be�ddod to t�e
<br /> estimated cost ar conCract price for permit fee purposes. In the eve,rit that t�aere is a dispute on the
<br /> anc►aunc of the job cost, the City may request the submission of a sig�ned capy oP the actual contrae�
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<br /> The undersigned heraby applies to the City�'or issuance of a Mechanical Permit, a�rees to do all
<br /> work in strict accardance with the ordinances of the City and the regulations af the State of
<br /> Ivlitinesota, and cortifies #ltat aIl statements made on this application ara complete, true and
<br /> correct.
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<br /> A,pplicant's Signature: Date. � o�.� ��
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