2014-00441 - gas line only - Laserfiche WebLink

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05/12/2014 10:17 7632592299 SCHULTIES PLUMBING PAGE 04/07 ❑ Yes,this sectipn applies The replacer�ent of a esidc�ti Lfixture.�avnlianc�that meets all three of thc following requirements: 1• D� 'i�at require modifcation to electrical or gas service, 2. Has a I cost of$500.00�r less;exc din ttie cost of the fixturc or applianx:and 3. [s improved,installed or rcplaced by the homeowner or 1lccnsed contractor. Skip next section,if this applics; Cost of Permit $_ 15.00 State Surcharge � _5.00 Mail-Tn Fee(If Applicable) $_ 2.00 Total Permi�t Fee S Tf above docs not appiy;follow guidclines below; l. RA T � CE °is 1.25%of contract price with a(Mittin�um F¢e of 550.00) � � x.0125$ +��,4� (contract pricc) (minimYm$.i0.001 2. STATE SURCBARGE � _ � x,0005 $ �� �OrnTBU pCicc} 3, POS?AGE&HAN.DLING(Only on Mail-Tn A.ppiications) $ z,pQ 4. TQTAI,PERMi�'FEE(Add Lines I,3 Above) $ � � � "` CONTRqCT PRICE or JOB C08T means the ach�al ar estimated dollar amount charged for the permitked w,or[c inclpding materials,labor,pro��,arid other fixed costs. It is the amaunt to bc charged co the customer for the work done. tf any material,equipment, labor ot instal.lations are funnished by the owncr,tenant or any other party,�,e reasonable market value of such items must bc added to thc estimated eost or contraet price for permit fee purkwses. 1,�the cwer,t that there is a dispute on the amount af the job eost,the Ciry may request tha submissian of a sig�ed copy of the aetual contraet The undersigned here6y applies to the City for issuan.ce of a Mechanicaf Permit,agrees to do a!1 work zn strict aecordanee with th� ordinane�.a of the City and the regul.ations of th.e State qf Minnesota, and certifics that all sratements rnade on this applica.tiota. are complete, true and cc�rrect. Applican.t's Signatu . �^ Date: � /+7 �J - 3