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MAR/18/2016/FRI 06:01 AM Heating & Cooling 2 FAX No, 7634283677 P. 004 <br />�• <br /> . , <br /> . � .� . .� �. �. � �`����,"r�� :�C' ., '-, .�'.-: ' �,�': . ;';;��� . . - .. <br /> . • .J� ':L4"'h�s::�.:,�•9.K:;,•�.�'.� J�".I.:1•' � . . .. <br /> ,.�.. . <br /> . . ... <br /> '..�. . '��'. <br /> . ... •. ... : .. <br /> . . <br /> '.. .. •. . . . . <br /> . ".�;,, .:'. ..' ... � . '� "�'� '�!'��'�'�.� � � <br /> ��.c�'.�:��1�x''���:���•. <br /> ❑ Yes,this section applies <br /> The replacement of a esidenti or a Ii ce that meets a1�three of the follovvix�g requirements: <br /> 1. oes not requixe modification to elecirical or gas service. <br /> z. Has a otal cost af�SQ0.00 or Icss;excluding the cost of the fixture or appliance:and <br /> 3. Ts improved, installed or replace$by the homeo�wxaer or licensed cantractor, <br /> Skip next section,if Chis applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Pee(If ApplicabIc) $ 2.04 <br /> Total�ermit Fee $ <br /> . � ,p.�T'�' �:�CALCU'�;��.3'��� — ���►:#��._.:�'. �.�':{�(2"., � :�; . <br /> Tf above does no€appl�;follow guidelines below: <br /> 1. CUNTRACT PRICE *is 1,25%of conlract price with a(Miuu➢mum Fec o(�50.00) <br /> ��' ��a � x.0125 S ��°� <br /> (co tract prtce) (aolntmum 550,00) <br /> 2. S ATE SXJYLCHA�GE <br /> ?�� b0. �t� x,p005 S� •�� <br /> (conuact pHca) <br /> 3. POSTAO�&�iANDLIN'G(Qaziy on Mail-Tn Applications} $ 2.pp <br /> 4. TpTAL PERMIT FE�(Add�.unes 1-3 Above) S��! �, �Q <br /> ■ '� CONTRACT pRICE o� ]QB COST means the actual or estimated dollar amouait charged foz the <br /> parinitted work inclrxdmg materials, labor,proflt,and ot3�er fixed costs. It is the amount to be charged <br /> to tha customer for the work donc. If any material, eyuipment, labor or installatioas are fiu�nished by <br /> the ovvnez,tenant or an� other party,the seasonable m&rket value of such items must be added to t�e <br /> estimxted eost or contract price for permi�fee purposes. Tn the �vent that th�re is a dispute on the� <br /> amount of the job cost, the Ciry may request the submission oP a signed copy of Che actual eonGract. <br /> .F. ��.i�'�v�b�l l' .��`,�F „\'.i�l:'� •�� ,aii $ � `� ' „`�. <br /> ����:��:.�i-�':xE��;:•;'i�;!,,:.:��:. <br /> The undersig,x�@d hereby applies to the Ci�y for issuanee of a Meehanical Permi�, agrees to do all <br /> work in strict accordance with the ordinances of#he Ci�y and the regutations of tkte State of <br /> Mxqnesota, and certifies that all state nts e on is application are couxplete, true and <br /> correct. <br /> AppIicant'sSignatu Date: �—�� �� � <br /> , � <br />