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1UL/14/2016/THU 06,01 AM Heating & Cooling 2 FAX No, 7634283677 P 004/004
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<br /> [� Yes,ihis section applies
<br /> 13e replaccment of a 1Zesiden�i�ixt�rF or appliance that rneets all three of tlie follawing requ�em�ts:
<br /> 1. Does not require modification to eleclrical or gas service.
<br /> 2. Has a total cos af$SOO.OU or lcss;c�acluding the cost of the fixture or appliance:arid
<br /> 3_ Is improvec�installed or replaced by the homeowner or licensed contractor.
<br /> Sldp next section,ifthis applies; Cost of Permit S ISAO
<br /> Stats Surck�argo $�,�
<br /> Mail-1n�'ee(If Applicable) $ 2 D
<br /> Total Permit�'ee �
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<br /> If above does not apply;follow guidelines below:
<br /> 1, CONTI7ACT PRYCE * is 1.25%of contrsct price with a(Ni�iaiunum Fee of SS0.00)
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<br /> �$�Q "� x.0125$
<br /> (coatract pxicc) (mtnimum$50.00)
<br /> a. smarE strncxAn��
<br /> X.000s $
<br /> (conuact pricc)
<br /> 3. PpSTAG�&HAN'DLING(�nly on Mail-7n Applications) � 2.00
<br /> 4. TQTAL PERMIT F'EE(Add Lines 1-3 Above). �
<br /> • " CON'7RACT PRiCE or 70B COST means the actual or estzmated dollar amouAt claarged for the
<br /> permitted work includ'mg materials, labor,pxofit,and other�ixed eoets. It is the amount to be charged
<br /> to the custozner for the work done. If any anaCezial, equipment, labor or installations are fi�oisb�ed by
<br /> the or�vne�r,tenaz�t or any other party, the reasonabie market value of such items rnust be added to the
<br /> estimated cost or cQntract pripe for permit fee purposes. In the event that there is a dispute on ihe
<br /> amount of the job cost, the City may requeat the submission o£a si�copy vf the actual contract.
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<br /> The undersigned hereb� applies to the Ci�y for issuance of a Mechanical permit, agre�s to do a,ll
<br /> work in strict accordance with the ordinances of the Csty at�d the regulations of the State df
<br /> 11tir�aesota, a�d ce�tifies that all statements made on this appliaation are complete, true an�d
<br /> corrac�.
<br /> Applicant's Signattue: Date: � ~
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