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Feb-08-Z002 02:09pm Fra�-CITY OF OROMO +9522494616 T-64T P.D06/006 F-Z48 <br /> P�R'M�T F.�E CALCULATIONiS� <br /> 2Q02 State_� ❑ Yes, This $et.h:ton Appli� <br /> The repl�cement of a �sidential fixture or a�plia�ce t iat meets all three. of tl�e following <br /> reqairements: <br /> I} Does nnt require modification to elecuical ��r gas service. <br /> 2) I�as a c�tal cost of$SOO.OU or less; excludiY g the cast oF t�fixture or appliance: <br /> an�i <br /> 3) Is improved, installed or repla�ed by the hc meowner or]ic�nc�d cor�ractor. <br /> Skip next secUon; Co:t af Pexmit $ 15.OQ <br /> Stat� Surcharge $ .50 <br /> Mai 1 I�F�e $ -1.50 <br /> If above does not apply, follow guidelines betow: <br /> i, Contract Price* i� .0125 % of joh wxth a iri' �m Fe�of(535.001 <br /> �x,�� _ x .0125 $ . <br /> (conuact price} (minimum 535.0� <br /> 2. �tate Su��h�e. ** Add the State Building Code Division a (M'mimuum Fe� of$ .SO) <br /> �j4� x .oOUS $ � <br /> (cadtracc price) '- (miaitiaxym� .so} <br /> 3, and (Only mail-in applicatioi w) $ .54 <br /> 4. TUTAL�'�12YVIIT 1+ + (Add li� 1-3 above) $ <br /> * CONI'RACT PRYC�or J�B�QST means the actual or estin t�tcd dallar ttmouac charged for the permitted <br /> work inciuding ma�erials,labor,prafit��other fixed vosts. It is the am�t ta be charged ta the ct�swmer <br /> for the work do�. If any material,equipmrat�labor�or ins allation are furnished by the ow�er� �enanc or <br /> at�y anc�r party tbe reas�abla�Ic�t value c,f such nems m��c be added to tbe esrimatai cost or contr�ct <br /> grice for permit fee p�uposes. In the event rb�c tbere is a disp<<te an the annaunc of tbe job cost,the CitY�Y <br /> requ�t the submission of a si�+ed�o�y Qf tA+:acaraJ couaac.. <br /> *w Ttu STATE S[JRCHARG&is.0005 of�he contract price und:r$I,OUb,00b or $.50-wl�h4wer is�ester. <br /> For valuacions over$1,000,000 caIl tbe l�eparcme�t of Ynspe xion Serviees frn the ptice, <br /> T`he w�lersign�ed hereb� applies to th� City for issuan�ce n�a Plumbing Fermit, agx�s to do all <br /> work in strict accorda�ce with the ordinances of the Cit y and the regulatians of tbe State of <br /> Mi�esota, � �e�tifies that all statements made on thi s application are complete, true and <br /> ctmtect. <br /> Apgli�at's Signap�re: �-�"~�_� `��— Date: � ����G� � <br />