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MAR/02/2016/WED 08;29 AM Heating & cooling FAX No, P, 004 <br /> 1. CONTItACT pRYC� *is 1.25%of conh�act price Witti a(Minimum Fee of$50.00) <br /> �i+7 x.Q125� �T��� <br /> ' aaact price) (min3�uuw SSO-ao) <br /> 2. STATL SURCHARGE C` �'�` <br /> l/ /�� x.0005 $ �, �� <br /> �aonhaor pr;ce) <br /> 3. POS'�AGE 8t�iA.ND�ING(Only on Mail-In Applications) $ 2.00 T <br /> 4. TOTAL PERMIT T�EE Add Lines 1-3 Above ����J . . � <br /> . � ) <br /> � ; CONTR.AGT PRICE or 30B COS'�means the actual or estimated dollar amoimt ch ged for the <br /> permitted arork including materiais,labor,pro��and othcr�ixcd costs. Tt is i�c amount to be charged <br /> to the customer for the work done, If any material,equipment,labor or iustallations are furnished by the <br /> owncr, tcnant or any other party, the reasonable �arket value.of such items must be added to the <br /> estimated cost or co�tract price for pernut fee purposes. Tn the event that thexe is a dispute on the amount <br /> of the job cost, the City zz�ay zequest the submission of a signed. copy of the actual contract. <br /> The undersigned hereby applies to the Gity for issuance of a Mec 'cal Permit, agrees to do all <br /> work in etrict accordance with the ordinance f the Ci d regulations of the State of. <br /> Minnesota,and certifies that all statem a o�th' icati are eornpl�te,true and correct. <br /> Applicant's Signature: Date:.��� /�j <br /> . 3 <br />