SEP/30/2016/FRI 08; 24 AM Heating & Cooling 2 FAX No, 7634283677 P. 004/004
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<br /> � . :> :,; � , Yes,rlus section applies , .
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<br /> ��ie replacement of a Residential fixture ar a�pliance tl�at:mee#s a11 tkaree ofttie following requirem�cnts: '
<br /> • 1, oea not require mpdificarion to electrical or gas sezvice. ��
<br /> ` `2. H�s a total coat of$500.00 or less;excludi ` the cost o�the�ixture ox appliance:and �
<br /> �: �Is improved,inatalled qx xe�laced by tk�e.homevr�vner or Iicensed contractor. ' ' ' � .
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<br /> ' ' 1v,tazl-zi�P�e,(z£A.�?Plicable) "$ 1:5�
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<br /> � ' �'above does not ap�lyi follow guxdelines b@1ow: ;' ' �'
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<br /> ` 1, �O1�T'�'RA�T._�'�tYC� �is 1,25%of ao�t�act�rxce wrth a(Nl�n�imum Fee of�35.00)
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<br /> _ (co traCt pricc) (minirrium$35.00) � <'
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<br /> ' '"�' dd�.State�,Idg Code piv,�urchaxge(Minimum Fee of S.Sp)
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<br /> 2; STATE SURCNARGE ?.
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<br /> ���l`�i-'�� x.000� $ c�� ., �
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<br /> ' ';.( ntract pri�y) Cminimum S .5p)
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<br /> 3 ;:�OS'�'AGE 8�,�.A.NDLING�O.uly ox�Ma�1�i APp"1a�ations) $; ' 1.50
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<br /> A �_TDTAL�PERMIT FEE{Add Lines I-�Abo�vc� $ � � ^�
<br /> � .* CON�`R.ACT PRICB or JO�# COST meana.the actual or estimatcd dollar a�in�ount �b,arged for the
<br /> pemutted work incl�ding materzals,labor,prQfit,�,d�ottier fixea cbats, It is khc a�Qum to be charged;
<br /> ' to"�e customer fvx txae wo�k dQne.'Yf any ixiat�xaal;equipment,l�bor or,install�2iona are furnished by
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<br /> ' '; thb,owner;tezzant oz an�dthcr t�ie �aspriaple�mark��value of such:items mnst,be added to the.
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<br /> est�mated`cost C�r �oi�tract. rice for permit fe��tirpbses. Zz�fhe event that.the e is'a dispnte:on tk�e.
<br /> ` '- amount of the,job cvst;tlie City rna�r mque��.the subrnissiorz;;of a signed copynf tlie actual,contract` : ��
<br /> "' . w'"'�'he STAT�SURC�GL is�QOOS of Che Building'Depaz�nent at(952)249-a600 for�hC price.
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<br /> � The ur�dexsiglied hercb�.applzes.to#he City for issuance of a 1Vlechanical pei�u.t; agrees to'do alI
<br /> work.in strict accprdance with�the ordinances pf�e;,�ity ar�d the regula�ions of.:txie State of �
<br /> 1V�in�,esota, '�nd cer�ifi�s, that�all statezn .mad ri �his applicatioaa axe conipletc, txue 'and � .
<br /> �orrect. .
<br /> �.ppIlCant'S Signature� Date:� � `�
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