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4 1.'x.6/2014 09:10 9524927729 ZAHLER HEATING & A/C PAGE 07 <br /> r rt r V,a w`�(t� i r ...,--.1,,,,,0'''k' 74"� fl ;J 10.41 t 4; br.• r �'" r,ii,i/ 1 4,,,i„ <br /> •, `)s{ PCi .�in �.. <br /> ,i M Yi ,( . C k u I GSr! )1° ICr' if I, r` 'il I N4M); <br /> �i n w'���� I�iJ�,•o�f"A 'ti$ ��'a i� + Gi ny � Sh ib� '� I i x � � ,1 'uT^� <br /> ,i7', � �'�Pa �� �...r. l'i " <br /> 0 Yes,this section applies <br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a total t of$500.00 or less;excluding the cost of the fixture or appliance:and <br /> 3. Is improved;installed or replaced by the homeowner or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-in Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> al M" w n *,rr,^n t Ny' .*fix', ii ',Eli Y <br /> If above does not apply;follow guidelines below' <br /> I. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$+0000)) <br /> .0 <br /> 244.1760 x.0125$ i11 • ;g <br /> (contract price) (minimum 550.00) <br /> 2. STATEAJRCHARGE <br /> ''Pt, 7,51) x.0005 $ _ �� •! <br /> (contract price) <br /> 3. POSTAGE& FIANDLING(Only on Mail-1n Applications) $ 2.00, <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 3 L . 5(0 <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 <br /> the 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 <br /> amount of the job cost, the City may request the submission of a signed copy of the actual contract. <br /> ... Ir,w. w.maM, .. gr:.,4-: ,,W,Tu"}.","7 .gT..a p rr41�rlwf 'u 1, 1 nw.wwrd rJi.n k '..# <br /> • 4.�. <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 statements made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: �_ Date: f 741 If 11 + <br /> 3 <br />