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' MA�/07/2014/WED 09; 22 AT� Heating & cooling FAX No, P, 007
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<br /> � 1'es,this section applies
<br /> The rcplacement of�Residential fixturc or ap�liance that meets all t}u'ee of the following reGuiroments:
<br /> 1. oe n reyuire modification to electrical or gas service,
<br /> 2. Has a totat cost of$SOD.00 or less;excludine,the cost of the�ixture or appliance:and
<br /> 3. Is i,znproved, installed or replaced by the homeowner or licensed contractor.
<br /> Skip next section, if this applies; Cost of Permit $ 15.00
<br /> State Surcharge $. S,QQ
<br /> Mail-Tn Fec(If Applicable) $ 2.00
<br /> Total permif�'ee �
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<br /> If abave doas not apply;follaw guidalincs balow:
<br /> 1. CONTR.ACT pRICE � is 12S°/a of contract price with a(Minimum�'ee of�50.00)
<br /> �L �� x.0125$
<br /> (cP uact prico) (minimum g�Q.DO)
<br /> 2. STATE StJRC�YARG�
<br /> �x.00QS ��
<br /> (contract prica)
<br /> 3. POSTA.GE&,HANDLING (Only on Mail-ln Applications) $ 2.00
<br /> 4. TOTAY,p�R1VTYT�'��(Add Lines 1-3 Above) $ �� ��
<br /> ■ * CONTRACT PRCCE or JOB COST means the aatual or estimaced dolIar amount charged for the
<br /> pez�rRaatted work including materials, labor,profit,and other fixed costs. It is the amount to be charged
<br /> to the customer for ch��uvork done. If any matcrial, equzpznez�t, labor or izzstaIlations are furnishcd by
<br /> the owner,tenant or any other party,the reasonable market value of such iterns must be added to the
<br /> esYimated cost or contract pricc 1'or p�rmik fee purposes. Za1 the event that tlaere is a disputc on the
<br /> amount of the job cost, the City may request the suhmission of a sigr,ed eopy of the actual contract.
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<br /> The undersigned hereby applies to tha City for issuance of a Mechanical Permit, agrees to do all
<br /> work in strict accordance with the ordinances of the City and the regula#ions of the 5tate of
<br /> Minnesota, and certifies that all state � s mad on this application are complete, true and
<br /> carrect. -
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<br /> Applicant's Signatuxe: Date: � ! �
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