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01l0412017 12:33 GLQWING HEARTH&HOME �Ax}952 492 6006 P.004I005 <br /> .,. , <br /> � _ �ro �M,"'- <br /> . . .. _ :. � �..,'. � <br /> 1. CQ�'X'RACT PI2YC� "is 1.25%of contracC price with a(Minimum Fee of SS0.00) <br /> �"��� x.0125$ ��"� <br /> (contract price) (minimura�50.00) <br /> 2. STA �S'C)'RCHARG� <br /> x_0005 $_ �.� l�� <br /> (contrect pricc) <br /> 3. POS'I'AGE&H.ANDT INCr(Onl�on MaiI-Tn Applications) $ 2.00 <br /> 4. TOT,A,X,pERMIT���(Add Lines 1-3 Above) $�� <br /> • * CONTRACx p�TCE or JOB COST means the actua[ or estimated doIlar amount charged for the <br /> pe�nitted work incSuding materials,labor,pro�t,and ather�xed costs. It is the amount to bo charged <br /> to the customer�or the work done. Yf any material,equipment,Iabor or installations are fumished by the <br /> owner, tenant or any other party, the r�asonable rnarket value of such items must be added to the <br /> �stimated eost or co�tr�eet price for permit fce purposes. Tn the event that there is a dispute on the amount <br /> of the job cost, the Ciry may request the submission of a signed copy o£ the actual contract. <br /> - �- - <br /> xhe undersigned hereby applies to the City for x5suance of g MeehanicaI Pe�iit, agrees to do all <br /> work iz� strict accordance wXtkA the ordir�az�,ces of the C�ty and the regulations of tk�e 8tate of <br /> Mitulesota,and eectifies Th�t alI stateme�,ts znade on tltis applicatior�are complete,true and correct. <br /> App�icant's Sigz�ature: �"`'�'~�:.�xt� �� ��� q <br /> , � <br /> 3 <br />