Laserfiche WebLink
From:COUNTRYSIDE HEATING & COOLING 763 479 2518 09/26/2013 10:22 #816 P.003I003 <br /> TPERMTT.�'EE CALCULATi�N{S) � �-� � fi�- �� <br /> - `' BASED OFF-2002 STA'3'E STATUB -� � ��`� � � <br /> -- ------- � :�"�' <br /> ❑ Yes,this sedion applies <br /> The replacement of aResidential fixture or appliance thffi meets all three of the following requirements: <br /> 1. Does not requile modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludinR Yhe cost of fhe fixture or appliance:and <br /> 3. Is improved,installed or mplaced by the homeowner or licensed conYractor. <br /> Skip next section,ifthis applies; Cost of Pennit $ 15.00 <br /> State Surcharge � 5.00 <br /> Mail-In Fee{Tf Applicable) $ 2.00 <br /> Total PermitFee S <br /> �_:.PE�M�`d'����A3.C�1i�A.3'���T�, :�J3�BS�����t���,(���}��������,��:- <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE *is 1.25%of contcact price with a(Ntinimum Fee of$50.00) <br /> � ( �'� x.0125$ <br /> (contract pnct) � (minimum SSOAO) <br /> 2. STATE SURCHARGE <br /> x,Q005 $ <br /> � (contrac[pnce) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) � 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S <br /> fl * CONT'RACT PRICE or JOB COST means the actuai or estimaYed dollar amount che�ged for the <br /> permitted wocic including materials,labor,profd,and other fixed costs. It is the amount to be ch�ged <br /> to the cvstomer for the worlc done. If�any maYerial,equipment,labor or mstallations 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 d�at there is a dispute on tlie <br /> amount of the job cost,the City may request the submission of a signed copy of the actual rnntract. <br /> �,z' _ _�r�'• ��';s�ar�,s�'r�. �`��'���'���.�•� '��.���'` �"� <br /> �a._� <br /> 'Ihe undersigned hereby applies to the City for issuance of a Mechanical Pennit, 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 comple[e, true and <br /> correct. <br /> Applicant's Signature: ��� Date: "Z —���I � <br /> 3 <br />