|
12/22/2014 13:44 FAX 9529aa5049 CULLIGAN MNTRA f�004
<br /> "' '�'S,�P��•`�':e�l� f� �� ,�'',,'�' �h.y..'ti,i�r� ��� ,.�, ,.+�1,'�',(� o�'Z•�r � �, �� ,'i��•—t c� dh w �
<br /> i ,i i Ir � 4 7�i �1 .�jA, � -u'�'.g Ik�.:•, '�,i.
<br /> tiw„ 1 , _t�,� ''� M. ?�: ..��tx�.��'.��',f�SiD5V1k�e�,t„i�a'oSwtiF;li: '�i,4�:'.^(
<br /> If above does not apply;follow gvidelines below:
<br /> 1. CONTRAGT PRICE 'is 1.25%of contract price with a(Minimum�ee oT 550.00)
<br /> x.0125�
<br /> (Contract price) (minimum$50,00) ,
<br /> 2. STA7'�SX7RCHARGE *'�Add the State Bldg Code Div.Surcharge(Minimum Fee of SS_00)
<br /> x.00�5 $
<br /> (contract price) (miniMum S 5.00)
<br /> 3. POSTA,GB&HANDLING(Only on Mail-In Applications) $ 2.00
<br /> 4. '1"p'�'AI.PERNIIT F'EE(Add Lines 1-3 Above) $ ��.Q�
<br /> ■ * CONTRACT PR10E or J'0$ COST mcans the actual or estimatcd dollar amount ehargcd for the
<br /> permitted work inCluding materials,labor.profit,and othcr fixed cosu. Iz is thc amount to be charged
<br /> to the customer for the work done. If any material, equipment, Iabor or instaliations arc furnished by
<br /> the owner,tenant or arry orher party,the reasonable market value of such items must be addod to the
<br /> estimated cost oc eontract price for permit fee purposes. In the event Chat there is a dispute on thc
<br /> amount of the job cost, the City may request the submission of a signed copy af thc actual conuae� ,
<br /> ■ **Thc STATE SURC�iARGE is.0005 of the contraCt prlCe undcr$1,Q00,004 or$5.00—whichever is
<br /> greater. For valuations over$I,000,000 call the�uilding Departrnent at(9S2)249-R}600 for the price.
<br /> ��� p+�, p7�'pry�j�, up��{�+ �1 .�, � �� ,,.���p,�+,��9�„�4r�� ,
<br /> .V�:M.� .dl'W )��+CI���'IMNeY�i�a 1 � �4'"h'�f1WT_._.�ll n[d'.�' vf+,1W�y�p'Y IfrG��ri}�,.�'PII.iY���
<br /> 9'�/+�1�".��1 1,.�4iL . 1'll�l
<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 ordinences of the City and the regulations of the State of
<br /> Mumesota, and certifies that all statements made on this app(iearion are complete, true and
<br /> correct
<br /> Applicant's Signature: V bat�: �v� —a�- �
<br /> ��'rt��,.,�,.�.c�F�Or„�, .
<br /> h
<br /> .{4!^•,1:7�i ,.l�lidP,.::jw.E:;.a
<br /> 3
<br />
|