2003-P06859 - plumbing - Laserfiche WebLink

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Ncv-15-2002 06:162M From-CITY OF ORONO +9522464616 T-41E P.003/003 F-155 IIS w i 9ER�IT FEE CALCULATICIYI,S) 20Stgle Stalute [ Yes, This Section Applies The replacement of a It si nt 1 fix i t meets all three of the following requirements: 1) �,y„W require modi/\� ical or gas service. 2) Hasa cost of$50u in the cost of the f cure or appliance: and 3) Is improved, installed e homeowner or licenced contractor. Skip next section; Cost of Permit $ _ 15.00 State Surcharge $ .50 i� Mail In Fee $ 1.50 If above does not apply, follow guidelines below: 1. Contract * is .0125 % of job with a Minlmum Fee of($35.00) kt J-(--�,�.- `, x .0125 $ .�a> • �-� -- (contract price) (minimum$35.00) 2, Stale Soh r ** Add the State Building Code Division a (Minimum Fee of$ .50) , (IQ<_ _ x .0005 $ of l , (contract price) (minimum$ .50) 3, Posta (Only mail-in applications) $ _ 4, 'TOTAL PERMIT FEE (Add lines 1-3 above) $ 5`F r. Oy * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including materials,labor,profit,and other fixed costs. It is the amount to be charged to the customer for the work dose. If arty material, equipment, labor,or installation are furnished by the owner, te^.art or any other parry the reasonable market value of such items must be added to the estimated cost or contract price for penait fee purposes. In the event that there is a dispute on the amount of the job cost,the City may request the slxbraission of a signed copy of the actual contract. w* The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or S.50- whichever is greater. For valuations over$1,000,000 call the Department.of Inspection Services for the price. The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements made on this application are complete, true and correct. Applicant's Signatur"-)r621x�_0� _ bate: