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05/12/2010 21: 51 6519948701 JANECKYPLUMBING PAGE 83
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<br /> If above does not apply;follow guidelines below:
<br /> 1, CONTRACT FUCJl * is 1.25%of contract price with a(Minimum Fee of$50.00)
<br /> ✓� -
<br /> 1600 ' x.0125$ 1-5)
<br /> (contract.pricc) (minimum.550,00)
<br /> 2. $TATE SURCIJARGE " Add the State Bldg Code Div, Surcharge(Minimum Fee of$.50)
<br /> 7w0 • x ,0005 $ 3 `
<br /> (contract price) (minimUnl$ .50)
<br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2,00.
<br /> Q3
<br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
<br /> • * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
<br /> permitted work including materials, labor, profit,and other fixed costs. Jt is the amount to be charged
<br /> to the customer for the work done. If any material, equipment,labor or installations are furnished by
<br /> the owner, tenant or any other party, the reasonable market value of such items must be added to the
<br /> estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the
<br /> amount of the job cost, the City may request the submission of a signed copy of the actual contract,
<br /> • ** The STATE SURCHARGE is ,0005 of the contact price under $1,000,000 or$.50—whichever is
<br /> greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
<br /> �'t'?'I�''Y',j,h"i:;�IpI:i�S'dw::+ '1,�, ;P I 6..��J��1i,„1 .r.,i� i !�;'��4, '�;J�.r���r.}ryy�:=';i;a,!�,�:�,}:����at!'�IrI
<br /> 5•. ,r :IP, l4'• Si:i,i , .i :� IPM„�� ,,. �:''�Jg t�++i�.a i Fno'."� u..h .'; i�i Y1 a i, 1`V
<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 ordinances of the Ciiy and the regulations of the State of
<br /> Minnesota, and certifies that all statements made on this application arc complete, true and
<br /> correct.
<br /> Applicant's Signature: ' 1' Date: (J lU
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