2014-01350 - mechanical - Laserfiche WebLink

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From:KLEVE HEATING AND AC INC 952 941 7240 11l18l2014 11 :37 #369 P.0041004 t . ;- _:.._.v:; ., .;: :: .� , bFF-200 -, ❑ Yes,this soction appliea Thc replacemeY►t of a Residentia that metts all three of the following requirements: 1. Does not require modification to electrical or gae servicc. 2. Has a total cost of 5500.00 or less;�ccludin$the cost of the fixture or appliaaco:aad 3. Is improved,installed�replaced by t6e homeowner or licensed contracwr. Skip next section,if this applies; Coet of Permit S 15.00 State Sw�charge S 5.00 Mail-In Fee(If Applicable) S 2.00 Total Permit Fee S � :�s:-�. �E C�AL�C[JLI'�� — 0 -:�. Yf above does not apply;follow guidelines b�low: I. CONTRAGT PRICE *is 1.25%of amh�act price with a(Minimum Fee of SS0.00) � � x.0125$ `J (c�act priae) (m+.mam sso.ie) 2. STATE SURCAARGE � ---^� x.0005 $ (�r�) 3. POSTAGE&HANDLING(Onty on Mail-In Applications) S 2.00 �- 4. TOTAL PERMIT FEE(Add Lines l-3 Above) S � ■ • CONTRAGT PRICE or JOB COST means the actual or eatimated dollar amount charged for the pemutted work including materials,labor,profit,end other fixed costs. It is the amount to bc charg� to the customer for the work done. If any material,equipment,labar or installations are fiunished by the owner,tcnant or asiy other party,the reasonable merket valne of such ite�ns must be added to the �timated cost or contract price for parmit fee purposes. In the event that there is a dispute on the amount of the job cost,the City may request the submission of a si�ed copy of the actual contract. . s , . _ :,,,, ,, . - CA�. i, �.�' The undersigned hereby applies to the City for issuance of a Mechanical Permit,agrees to do all work in strict accordance with the ordinances of the City and the regulatiotts of the State of Minnesota, and certifies that all statements made on this appIication are complete, true and correct. Applicant's Signa ' Date: � 3