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Ncv-13-2�02 68:iBam From-CITY OF ORONO +8822464616 T-4?8 P.003/003 F-163 <br /> 'I <br /> p��,�vrTT �E CALCULATICl�� <br /> 2�0 _2_State�,�g ❑ Yes, ThiS Secdon Applies <br /> The replacement of a �esi ial fix��. �►nnli nce that meets all three af the foilowin8 <br /> requirernents: � <br /> 1) �,� requixe modi rion elecuical or ga� service, <br /> 2) Has a to cost of$500. less; udin the cost of the fixture or appliance: <br /> ana <br /> 3} Is irrtproved, inscalled � replace b� thc homeowner or li�enced contractar. <br /> Skip next sect ; tCost of PerrRii $ 5 <br /> �tate Surcharge $ .SO � <br /> Mail In Fee $ 1.50 <br /> Tf abovc do�s not apply, follow guideliz�s below: <br /> 1, � ntrac �* is ,0125 � Qf}ob with a Minimurn Fee of�$3S.Q02 <br /> � � <br /> � �; �,(� x .0125 $ v�,�I �'�-�� <br /> (concract price) (miniuxum$35.Q0) <br /> 2, St, at�S rc� r . "* Add the State Building Code 17ivision a (1Vl�nimu�a Fee of$ .50) <br /> Fx 1 � t � .00as � ,.�, ; c- <br /> , ��C.�c� � � <br /> (contract pricc) (��'���' �3a� <br /> 3 �„� (C3nly mail-in applicaLiorys) � �..-- <br /> 4, '�'pTAY,p�RMIT FEE (Add lines 1-3 above) $ '-�'��.�'�`� � <br /> * CdN'1"RACT'PR1C�ar J�B CUST means the actual or estimated dollar amounc char�ed Pas thc perm'st�ed <br /> wark includ'utg materials,labos,profit,anQ o�:�r fixed casts. Ic is thc amounc to be c!�arged co che cusroma� <br /> for the work done, If any macerial, equipment, labor,or iustailadon&re furaishad by the owner, tena3lt or <br /> �ty othex pa�ry the reasounble market vAlue of such items must ba added tv thc esdmated cost ar eontract <br /> price for percnit fec pur�oses. In the event that shere ts a dispuie on tt�amouni of tt�t jab cos�,ttle Ciry muy <br /> rcqucac the siabznission of a signed copy of rhe acrual contracc. <br /> ' w� 'T'�e STAT�SURCHARGE is .00C}5 of the contract ptice under$1,QOO,Q00 ar $.50-whicY�.ewcr is �re�ter. <br /> rar valuations over$1,000,000 call the 1?eparcmenr•of Inspte�ion Scrvices for rhe price. <br /> The undersigned t�ereby applies tQ thr City for issuanc� of a PlumbirAg Permit, agrees to do all <br /> ; vaork in strict a�c;orda�ee with the ordin�nccs of the Ciry and the regulations of ttie Staie of <br /> i lvli.nncsoza, and certifi.es that all staternents madc on this application are com�lete, true and <br /> carrect. <br /> � _ <br /> Applicant's Sigz�axure:•._1`.%� < � ,z1 .�,;�, T�ate:��'/� <br />