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05/06/2010 12:10.FAX 9529335049 , CULLIGAN MNTKA f�004
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<br /> If above does not apply;follow guidelines below:
<br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$35.00)
<br /> � x.0125 $
<br /> (coiitract price) (minimum$35.00)
<br /> 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of 5.50) -
<br /> x.0005 $
<br /> (contract price) (minimum$ .50)
<br /> 3. P03TAGE&HANDLING(On1y ori 1Vlail-In Applications) $ .—�6' o��Ou
<br /> 4. TOTAL PERMIT FP1E(Add Lines l,-3 Above)� � '� �S v
<br /> • * CONTRACT PRiCE or JQB COST means the actual or estimated dollar amount charged for the
<br /> permitted work including matezials, labor,profit;and other fixed costs. It is the amount to be charged
<br /> to the cvstomer for the work dona. If any material, equipment, labor oc installations are furnished by
<br /> the owner,tenant or any other parly, 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 /> a�nount of the job cost, the City may request the submission of a signed copy of the actuaI contract.
<br /> ■ ** The STATE SURCHARGE is .0005 of the contract 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. j
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<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 City and the regulations of the State of
<br /> Minnesota, and certifies that 'all statements made on this application are complete, true �and
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<br /> correct. �
<br /> Applicant's Signature: _� �� Date: 5 - � • ( �
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