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MAY/12/2015/MON 02:58 PM Heating & cooling FAX No, P. 002 <br /> 1 <br /> :f <br /> Q I es,t4us aectiaa applies ..'r <br /> C <br /> The replaceruent of aesideiatialfi <br /> e or appliance that meets all three of the followW requirements: <br /> 1 ,.1. <br /> 1, boes'not requiremodification to electrical 6r.-gas seiVico. <br /> 2. Has a total cost of$500.00 or les;exclu the cost of the fixture or appliance:and <br /> •3,. Is impiovad,iristallcd:or replaced by'the houkeowner or,licensed'contractor. <br /> d. <br /> Skip next section,if'thisapplies; Cost of Permit .` $ 13.00 <br /> SSte$urchare, $ .50 <br /> fail-ln 7+ee(ff Appkcable) $ <br /> Total Berndt Fee'. <br /> S M. Kal <br /> If above does not"apply;;foliow guidelines below r <br /> 'CONTRACT PRItCE *is 1.25 Yo of contra6t*ice w14a(Muumum Fee of 535.!!0) <br /> x 0125 <br /> •(9ot�tractprice) (miriimum$35.00) t <br /> 2. STATE SURCHARGE «*Add tlse Stae.Bl Code D'v <br /> Surcharge(rliaitnttut Fee bf <br /> 77 <br /> X.008 <br /> , (conhs�tpnbC) :(rrun{rltum$ 50)� ;'1 <br /> 1 <br /> 3: POSTAG &HANDLING Onl n 1Vlail-In ` p lice <br /> E ( ,y a App tions1.5Q f <br /> 4.,TOTAL PERMIT FEE(Add Lines 1=3 Above) $. <br /> CONTRACT PRICE;oi JOB COST.'mean$tha actual.or estimateddollar amount charged foi;the <br /> , <br /> ding <br /> perwitted work inclu materials,labor,profit,and other fixed costs. It is tfie bmount to be c ged <br /> to the customer fox'the wgrk done.' If any mate;ia.,'equipment,labor or instaIlatione are furnished by' <br /> the owner,tenant or any other party,the reasonable i a iqt value of such items must.be added to the ' <br /> estimated cost'or contract price for permit fee purposes. In the event.that thereis a dispute on the <br /> amount of,the job coat,the City may request the submission.of a,signed copy of the actual contract. . <br /> **The STATt SURCHARGE is.0005 of the Building Department at(952)249.4000 for the price. <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: ate: <br /> 3 <br />