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16l26/2011 12:65 • 9524960064 APPLIANCE CONNECTION PAGE 01/01 <br /> � "P�RI�IIT.FEE.�C.A:LCi,lIa4`�"ION S.-JOSS.O��?E���.5�1(1:0�0'. . <br /> (f above dces aot apply;follow guidelines below: <br /> 1. CON'fRACT P�� *is )25%of conuact price with a(Mipimuaa�ee o�550.00) <br /> x.0125� <br /> (c�nact price) (minimum SS0.00) <br /> 2. STATE S�1�CHA�G� "`*Add the State Bldg Code Div.Surcharge(Minunua��ee oiS5.00) <br /> x.0005 $ <br /> (conaacs price) (minimum S 5.00) <br /> 3. POSTAG�&HANDL[NG(Only on Mail-�n Applicatio�s) $ 2.00 <br /> 4. T01'AL PE�x'i k'��(Add Lines 1-3 Above) S <br /> ■ s CONT'RA,CI' P�t10E or JOS COST means the actual or estimased dollar amount cbarged for the <br /> pe,rmitted wurk including materials,labor,pmSt,and od��fixed costs. lt is the amount to bc charg� <br /> co�e customer for the work done. If any material>equipmar�t.tabar ot insfiallatio�s are�1,mished by <br /> the ovmer,tenant or arry othe.r parry,the reasonable market walue of suck� items must be added to the <br /> estimated cost or contract price for permit fee pwrposes. ln xhe event thac there is a dispute on rhe <br /> amount of the job cosc,tbe City may request the submission of a signed copy of the actual con�ract <br /> ■ "'�The STATE S URCHARGE is.0005 of the contracC price uxider S 1,000,000 or 55.00—whichever is <br /> geater. For valuabons over$1,000,000 call the Buildis►g pepartrnent at(952)249-4600 fo�the pnice. <br /> � � �PT�UA�BIl�TG'P�RMT�';A:FPL�C�4'I':iO�T.'ACr��'':...� . ' � <br /> The undersigted h,ereby applies to the City for issuance of a Pliunbing Permit, a,grees to do all <br /> work in strict a�ccordance witla tt�e o�rdinartces of the City a�ad the regulati�o�as of t�e State of <br /> (v�iranesota, and certifies that all statements made on this applicarion are complete, true aaad <br /> correCt. <br /> 0 <br /> Applic�t's Signatw�e: , Date: '� � I <br /> Re¢et;Fbi�rl <br /> � �"`�,.,�rs � � <br /> � � <br /> 3 <br />