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MAY/07/2014/WED 09:21 AM Heating & cooling FAX No, P, 004
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<br /> ❑ Yss,this section applies
<br /> The replacement of a Residential fixture or appliance that meets all thrte of the following requirements:
<br /> l. Does not require modification to electrical or gas service.
<br /> 2. Has a t co of 5500.00 or less;exciudine the cost of the fixture or appliance: and
<br /> 3. Ts improved,installed or replaced by tha homeawner vr licensed cantractor.
<br /> � Skip next section,if this applies; Cost of Permit � 1��Q
<br /> State 5ureharge $ 5.00
<br /> Mail-In Pee(lf Applicable) � 2.OQ
<br /> Tpc�►�����t�� s
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<br /> If above does not apply;follow guidelines below:
<br /> 1. CONTYtAC"T PRTC� '"is 1.25%of conaact price with a(Minfmum T�ee o!$50.00)
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<br /> x.0125$
<br /> Contraot pri ) (minimum 550.00)
<br /> 2. S�'A,TE SURCHARGE
<br /> x,0005 $
<br /> (ca�ect price)
<br /> 3. T'05TAGE&�TANDLING (Only on Mai1-In Applications) $ 2_00
<br /> 4. TOTAI.PERMIT��(Add Zines 1-3 Above) �
<br /> ■ * CONTRAC�" PRZCE or JO� C05T means the actual or estimsted doIlar amount chiarged for�he
<br /> penn7ued work including materials,lahor,profit,and other fixed costs, It is the amount to be charged
<br /> to th�e customer for the work done. If any material, equipment, labor or installations are furnished by
<br /> the owner,tenant or any orher party, the reasanab�e market value of such items must be added to the
<br /> estimated cost or contract price for permit fee purposes. Tn the event that there is a dispute on the
<br /> amount of the jeb cost, the Gity may rec�vest the submission of a szgned copy of the actual contract.
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<br /> The undersigned hereby ap�lies ta the Gity for issuance of a Mechanical Permit, agrees to do al]
<br /> work in strict accordanoe with the otdinar►ces.s of the City �nd the regulations of the State of
<br /> Minnesota, and certifies that all st&tentctlts madt on t ' pplication are compiete, true and
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<br /> Applicant's Signa'tur . Date: �
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