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. �L�u/03/2015/WED 01 ;01 PM Heating & cooling FAX No, P. 004 <br /> . , . : ,- . ��'�r�r.r..:���,:,. ,. ��;. V;,�;t��, �,�,-- : : .. <br /> . - ;.,...;,.��:- �,�_�..; �;����.�:��..: � <br /> � � :'8���o�����;::��:sT�;����;��. � ,.� <br /> ❑ Yes,tlus section applies <br /> 'T'he replacement of a Residen ' 1 xture or a li o that meets all three of the follovving requffements: <br /> 1. Does not royctire modification to electrical or gas service. <br /> 2. Has a total cost oF$SOD,00 or less;exclu ' the cost of the fixture or appliance:and <br /> 3. Ts improved,installed or seplaced by the homoovvner or licensed contractar. <br /> Skip next section,if this applies; Cost of permit � 15.00 <br /> State Surcherge $ 5,00 <br /> Mail-Ia Fee(If Applicable) $ 2Ap <br /> Total permit k'ee S <br /> ' � � PER1UfIT F�E�CALCUL�T�. =���:��:;�7}. -- �00'�'4?p" � � ,�.Y. <br /> If above does not appiy;follow guidoliues below; <br /> 1. NTRACT PRI *is 1.25�/a of conaact price with a(Minimum Fee of gS0,00) <br /> a� <br /> "' x.0125$ �Q� <br /> (coouacaprice) (min mom$50.00) <br /> 2. srAr�sY.rnc�aRc�� dcy <br /> . ��C�. x.000s s ,� � �U <br /> c�,��Pri�� - <br /> 3. POSTAGE&HANpLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TO'�,�L PERMTT�'E�(Add Lines 1-3 Abova) $ �LJ��D <br /> • �` GONZRACT PRIC� or JOB COST means t'he actual or estamated dollar smau�at charged for the <br /> permittad wprk includmg xnatarials, laboa,profit,and other fixed costs. It is the amouat to be charged <br /> to the customar for tb,e work done. Tf any material, equipment,labor or inststatlatioa9 are furnis�ed by <br /> the owner,tenant or sny other party, the reasonable market value of such items must be added to t�e <br /> estimated cost or contract price fvr permit fee ptn�poses. In the avent that there is a dispute on the <br /> amount of the job cost, the City may request the submission of a signed copy of the actual contract. <br /> :�� :���rrlc�, �� ���. 5. ,:a�;:�..:�:�: .:,�.;. <br /> _ .';�A�};:'.„�;.��•� <br /> The undersigned hereby applies to the City for issuaace of a Mechanical permit, agrees to do all <br /> wor�C up strict accordarlee with the ordinenees of the City and the regulatio�as of the State of <br /> M�ixuaesota, and certifes that aIl statements tt�ade on this application are complete, true and <br /> correct. <br /> Applicant's Signature: � Date: (�'.�r <br /> . � <br />