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, � Ncv-15-2�02 08:19am From-CITY OF ORONO +p6224o4616 T-<!E P.003/003 F-165 <br /> . <br /> �"'e`��'�' r'A 1" �ATI4 (S} <br /> �._:_-- � <br /> 2002 State StaLu�� Q Yes, This Secdon Applies <br /> The replacement of a i ntial c tbat�ieets all three og the toilowing <br /> rcquireme�s: \ <br /> 1) p�,� require modificati to �lectric•�1 or gas scrvice. <br /> 2) Has a tQtal cost of$500.00 or ; ex�`ludine the cdst of the fixture or appliancc: <br /> �d � <br /> 3} IS improved, installed ox replac b�thc homeowner or liceneed coatractor. <br /> \��ost of Permii $ 15.00 <br /> Skip next scction; -- <br /> State Surchar�e $ .$Q - <br /> Mail In Fee $ 1.50 <br /> / <br /> Tf aboye does r.�t apply, follow guidelines below: <br /> 1. ntra�t �* is ,OF25 °�b of}ob with a Minim�m Fee of(S3S.001 <br /> � S, 5cx� `��' __ X .oiz.� � 4 ��I . �� <br /> (conmiCt prlce) (minianim 535.00) <br /> Z, ** Add the State Building Cod� T)ivision a (11�tinimurn Fee af$ .50� <br /> � c;c : — <br /> ��i ,�`�' X .0005 �S �� o . <br /> {coatract price)^� (minimum$ .30) <br /> g. posta� and��II�lj� (Orily mail-in applications) $ _ � <br /> 4 �p�,�,p�grrIIT FEE (Add lines 1-3 above) $ JCL,` � <br /> « CpNTRAC'1'PRTCE or JOB COST m�abs tt�e aetua.l or estimated dollar arnounc char;ed foz thc permitted <br /> work includir►�mat�rials,labar.Profl:,xna o�er flxed easts. It is thc amount to bc c�arged to the cusromec <br /> for tbe work ctoae. If�ay mazerial.�4n�Pment, labor,or inscalladon are f�raishod by the owner,uns�at or <br /> aa�otbet pa�zy chc nasonsblc market vAlue of such items must be add�ed to the esdmared cost ar contract <br /> price for pennit fa p��g, In the event th�t W�re l�a dispute on�amonni of thr job cos�,t�e Ciry may <br /> reques�tht submission oi t ai�ned eopy of tbe actunl eontract. <br /> +* '1he STA^fE SURCHARGE is .0005 of tha contraet pric�uader 51,000,000 ar $.50-whic�evcr is �reater, <br /> For valuadotts over 51,000,000 call me Qeparcment of Incpecticm 9ervices for che price. <br /> The undersign�d hereby applits to thc City for issuanc� of a Ptumbing Permu, agrees to do all <br /> work in strict acr.ordance with the ordinanccs of the Ciry aixl the regulatioas af the St.ace of <br /> Milmesota, and certifies thac all statements madc on this applicatioa are camplete, true and <br /> correct. <br /> Applfc�nt's Signanue:,,f ' � ��� ti _ DaLe: //- /�C <br />