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. . ,From:KLEVE HEATING AND AC INC 952 941 7240 01l06l2014 10:54 #017 P.0031005 <br /> ❑ Yes,this section applies <br /> Ttie replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> 1. Does not rrquire modification to electrical or gas s 'ce. <br /> 2. Has a total wst of 5500.00 or less;excludine the c st of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeo or licensed contractor. <br /> Skip next section,if this applies; Cost of P 't S 15.00 <br /> State Surc ge $ 5.00 <br /> Mail-In F (If Applicable) S 2.00 <br /> Totxl Pe t Fee S <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of con4ract pric with a(Mlnimum Fee of S50.00) <br /> O x.0125� l�'U��S <br /> (conhact pricc) (m�imum 550.00) <br /> 2. STATE SURCHARGE ��� <br /> c���;��, <br /> X.0�5 $ z. �s <br /> 1 <br /> 3. POSTAGE&HANDLII,TG(Only on Mail-In Appli ations) � 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) a �I��5� <br /> ■ " CONiRAGT PRICE or JOB COST means the actual r estimated dollaz amount charged for the <br /> permitted work inclttding materials,labor,profit,and oth fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material,equip ent,labor or installations are furnished by <br /> thc owner,tenant or any other party,the reasonable mark value of such items must be added to the <br /> estirnated cost ar 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 submiss on of a signed copy of the actual contract. <br /> The undersigned hereby applies to the City for issuance f a Mechanical Permit, agrees to do all <br /> work in strict accordance with the ordinances of the 'ty and the regulations of the State of <br /> Minnesota, and certifies that all statements made on is application are complete, true and <br /> correct. <br /> Applicant's Signa ( Date: 1— �9—�� <br /> 3 <br />