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O1/14/2014 13:47 FA% 9529335049 CULLIGAN ffiNTKA C�004
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<br /> If above does not apply;folIow guidelines below:
<br /> I. CONTRACT PRICE *is 1.25�0 of contract price with a(Minimum Fee of 550.00)
<br /> x.0125$
<br /> (conlrect price} (minimum$50.00)
<br /> 2. STATE�URCHARGE '�*Add the State Bldg Code Div.Surcharge(Minimum Fee ofS5.00)
<br /> x.0005 $
<br /> (contract price) (minimum S 5.00)
<br /> 3, POSTAGE&HANDLING(Only on Mail-in Applications) $_ 2.00
<br /> 4. TOTAL PERMIT F'EE(Add Lines I-3 Above) � o�o�• 0 V
<br /> • * CONTRACf pRICE or JOB COST means the actual or estimated dollar amount charged for the
<br /> permitted work including materials,labor,profit,and other fixed eosts. 1t is the amount to be charged
<br /> to tha customer for the work done. if any material, equipment, labor or installations are fumished by
<br /> the owner,tenant or any other party,the ressonable market value of such items must be added to the
<br /> estimated cost or eontract price for permit fce purposes. In the event that there is a dispute on the
<br /> amount of the job cost, the City may request the subrnission of a signed copy of the actua] contract,
<br /> ■ *'`The STATE SURCHARGE is.0005 of the contract price under$1,000,000 or$5.00-whichever is
<br /> greater. For valuarions over$1,000,000 call the Building Departrnem at(952)249-4600 for the price.
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<br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
<br /> work in strict accordance with the ordinances of the City and the regulations of the State of
<br /> Minnesota, and certiftes that all statements made on this application are complete, true and
<br /> , correct.
<br /> ApplicanYs Signature: � Date: I- (y - f y
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