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05/19/2014 14:13 9529127394 CULLIGAN HR PAGE 04/04 <br /> f � ' � <br /> r ,�;;PER�nI'�� C.�L�UI..A:7'I�S1� � , , <br /> --JO�.S C�''4'E�t��40';UD <br /> ITnbovc does noc appfy;Follow guidelines bclow; <br /> I. CON ,RAC'�p CE * is ].25°'0 of cor�tract price with a(M;ninn�um�'ee of$5�.00) <br /> x .p125$ <br /> (cantract pnca) (minimum$SO,DO) <br /> 2, STATE SURCtiARC� *"Add th�State Bldg Code Div.5urcharge{M;nim��m Fee oT$5.00} <br /> x .Q005 $ <br /> (contrsct pricc) (minimum R s.00} � <br /> 3. PQSTf1G�&i-iAND�,ING(Only on Mai!-ln Applications} $ 2 p� <br /> 4. TOTA�,PERIVII7"FEE(Add Lincs 1-3 Abovc) � �� V� <br /> ' �` CON"CRACT PRrCE or JOB COST mcans the actual or estimated dollar s�m�unt charged for the <br /> permitt�d work inCl�idin�mateTiAls, labor, profit,�nd athcr fixed costs. It is the amount to be charged <br /> to thC cvstome�r for the work done, 1f any material, equipmCnt, f8b�e ot'instaJiations are furnishcd k�y <br /> i'h�owner,tenant or any other party,the repsonable mArket v�lue of suckl items must be added �p the <br /> esti�ltated cost or contract price for permit fec purposes. In zhc event that there is a tlispqtc on ihe <br /> amount of th�job cost, Che City may rec�ucst ihe Submission of a signed copy of the petual eonh�Act. <br /> " ** The STA'1'E SLJf�CHARGE is.0005 of thC contract price under$1,QOO,D04 or$5.00�-whichever is <br /> grea.ter, For valuations over$1,400.04p calf the Buifding Depar('rnent st(9S2}249-4600 for thc pricc. <br /> ��1�'`F���1 �I(�}��f}�;II �ii4"�IN�M � � ' y�� ��,rr <br /> M � 'n <br /> . .. , „ , �� , �� • �'��TIi� ; ' � p� �,�- <br /> " r 1V,:�'_1�41��'� ��'r�p�r . ��i�ill'������f'ti�f�� ��;ii�.�H <br /> �:71. <br /> The undersigned hereby applies to the City fvr issu.ance of a Plumbing Perrn;it, agreeS to do al1 <br /> work in s�ri�t qecordance with the ordinances of the Ciry and the regulations of the 5tate of <br /> Minnesota, and certi�es that ail statemer�ts mad� on this application are �omplete, true and <br /> c�rrect. <br /> Applicant's Signature; �� � ^ f <br /> I�ate: <br /> n�������,��� <br /> ni :;;<<,�i:, <br /> i <br /> 3 � <br /> � <br />