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05I2412016 12:11 Riccar Heating �A}�}763 75d 0132 P.004l004 <br /> � <br /> _ , •�, . PERMIT FEE•GAI.CLT�,A,TIONS' , � _ . <br /> 1. CONTR�,CT PRIC� *is 1.25%of contract price with a(Minimum Fee of$54.00) <br /> c�Q •� x.0125$�ryy� <br /> ( ontcact price) nimu S$50.00) <br /> 2. STATE SURCI•IA12CE / �J � /('/ <br /> L.��2 �d• � x.00OS $ � 1S <br /> (contract priCp) <br /> 3. POSTAGE 8c HANDI,ING(�nly on Mail-In Applications) $ �Q�� '� <br /> 4. TOTAL PERMI'�FI��(Add Lines 1-3 Above) $ � ��- �� <br /> ■ * CONTRACT PRiCE or JOB COST means the actual or estimated dollAr amount charged for the <br /> permitted work including materisls, labor,profit,and oeher fixed costs. It is the amount to be eharged <br /> to the custnmer for the work done. If any material,equipmcnt,labor or iastalfations are furnishcd by the <br /> ownar, tenant or any other purty, the ressonAble market value of such items must be added to the <br /> estimatad cost or contract price for permit fee purposes. In the event that there is a dispute on the amount <br /> of the job cost, the City msy request the submission of a s;gned copy of the aetual eontract. <br /> _ �cz�;ri�c�.z.i��ruvnr ap LY�ai�QN;�G�Em�rrT � <br /> The undersigned hereby applies to the City for issuance of a IVlechanle&1 Permit, agrees to dp all <br /> work in strict accordance with the ordinances o�the City and the regulations of the State of <br /> Mirviesota,and certifi at a 1 statements made on this application are compleCe,true and correct. <br /> , ` <br /> Applicant's Signat Date: �/�`�/ <br /> 3 <br />