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Oct-IA-t003 04:34ps Fro�-CITY Of ORONO � +i522414616 T-358 P.003/003 ,.�-6t0,, <br /> `i . • ¢,� . .� '4� . : . ... -�*"n <br /> �. . ..+� . � � , �r`Vr. . ,�Y��.... ��{ <br /> • , . ��� . � • . � ��'4� f ga� . <br /> • •.� ..� �. . ' ' � 7'fi�,�'� *.. <br /> . � N°� ro <br /> . ' � `,,� _ . ' .v °1j'�'� �,;y <br /> N - ���:, �� �� <br /> ��P <br /> 2002 Smte Statute ❑Ya TWs Sectiaa Appltea _ <br /> The repIacemer►t ofa 'a tl�st t�eta atI t�e oi�Q foll <br /> ow�aS�9�: � <br /> 1� �iM�u'iodi8cation t�eleeaical or Bas savice. <br /> 2) Hss a 1�of SS00.00 or lesa;�cl��cost of the fuctur�e aa�appliaace: <br /> end <br /> 3� ��v�d,instaUed or replaced by d,e homeowna our licensed concacto�r. <br /> Slap next sectiaa�; . Cost of Peemit S_ 1 S.n '• <br /> State Sutchar�e S���� <br /> Mail-In Pa S_ ls� . `— <br /> .. .,,,_ . <br /> If abor►e does not appIy,tbllow guidelines below: . <br /> l. trac P,r�*is.O12S°Yo of job with a�n�um Fee of s_�� . <br /> � ��„_x.0125 s c� <br /> . ���°� tfiinimma S3s.00) <br /> 2. ta a **Add the St�te Bw7diri�Code Divisioa a <br /> • �.vm Fae of!S 4m <br /> x.00p5 s <br /> ����� (miaimma S.SO) <br /> 3.p.s�slage and H�tndlinF(pa�j.a�a�!-tii apptkadaurs) � <br /> S _ 1 tn <br /> a.TOTAL PERMIT FE�(Add lines 13 above) S �� . . <br /> 'CCN7RACT PWCB or JOB CQT'C meane t!��cwa!or . <br /> �ials.hbor,Pro����fuced costs.It is the aino��timued dollu ano�mc cb�rged for d�e perpdcted w�nrlc inctudip � <br /> W�P�hbor.or inseell�don is furaiahed b du owner ��oo che a�oornc fbr tAe wark d�e.If�►y nn�taiial. <br /> must be added w d,e euimued eosc or eoneraa •�da�a ar�nr oeha p�riy ehe re�bk��us otsaeh tiaas <br /> tht job cosc.the Ciry ntay requat the tubtassioa�of�����.(a du evept t}�St thue is t dtspux on We amouer of <br /> • �d�of tbe a�!coq�acr, <br /> ••7he STATE SURCHARGE is.00OS oiqu cau�aet P�p under 51.000.000 or S30-wbicherer is gK�r,Foe valu�ioAt over . <br /> t 1.000.000 all the Department of Inspection����� . <br /> The+n+dasigned h�s4y tppldes to tlte C,ry[or iasur�ica oi�A�ech�ntal Penni��to do dl work ia atria aorondanp with <br /> dia adinances of the Ciry uid the reguluiona otd►e Mint�esoe�Snoe BuUdinj Cade.and certi8�s duc�Il u��e oa this • - <br /> •AN��aaon are eomptea�onu and ee,7ec�, <br /> Applicant's Signature: . <br /> Date: p <br /> Approved By: . <br /> Dste: <br /> 3 <br />