y�,a''��x-�"•` �.er�K .� sr v'� �: "�. �kr: .- :r,��c°R'r :i' �n"' A�!�f�'" #3.�`x..�CR :.Y�,'�"`� �+':�. �.a�: �•-i„ 1+y.�-.�".
<br /> � - �� t,�y � W S �_.F � �: ��t�.�d h � �. �. 'r � � t :` 'u? � :�, Ai 4i'^y �'*# �S r a^"`^�� m �'
<br /> �.� ,�, ��. � '�,.% � � r � � � _ `§��x ,��� fi' �r 4'h .�3.��v� kn�.. ��. e�� +���'�� ,,,�� �E` .�.F�}�
<br /> ..�' t� r't +�� _r k av �: -<. ,v �,a Y''� -i � -. te u-p� fi k.�� �. s�'YtNr '�r r�� *�,�, a' .,r,y, ` W'`';s
<br /> .�f��- �?.� ''�r; �.. �� � 5c5 9 ''pr . �,z°°'z� � i° �ir .�"'kF".� �'��r,*i.... 3 yr�,�� � ��� s,�^�`� -�, �s ' `.
<br /> r5Y a �'a,��ct y '�.�: a,`�-. �+ "4��''��f� i`a a„*e-. `�.
<br /> F a.
<br /> . .�_ + m � a
<br /> �`s. ` �k_�`. ,a,Mt..;�i�'�tF,. ,�"r-..'+a. �S�t�ri:= ,��',a�.��}�. �v s�.�t�r� '�.i�'-`.�?riri'rc. �;. a -
<br /> _ .�. ,,
<br /> _ .., .
<br /> :.� � .
<br /> PERMI� FEE CALCULATION
<br /> 1. 1.25% of Contract Price* or Miiti,�num Fee ($35.001
<br /> -'�C�� x .0125 $
<br /> (contract price)
<br /> 2. State Surcharge. ** Add the State Building Code Division
<br /> Surcharge to each permit. x .Q005 $
<br /> (contract price)
<br /> or $.50, whichever is greater
<br /> 3. Postage and Handlin� (Only mail-in applications) $ 1.50
<br /> �,
<br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $
<br /> * CONTRACT PRICE or JOB C05T means the actual or estimated dollar amount chazged for the permitted
<br /> work including materials, labor, profit, and other fixed costs. It is the amount to be charged to the
<br /> customer for the work done. If any material, equipment, labor,or installation aze fumished by the owner,
<br /> � tenant or any other party the reasonable market value of such items must be added to the estimated cost
<br /> or contract price for pernut fee purposes. In the event that there is a dispute on the amount of the job cost,
<br /> the City may request the submission of a signed copy of the actual 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 Department of Inspectional Services for the price.
<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
<br /> correct.
<br /> . �;
<br /> \ ' I � � ('} �'
<br /> , 1�-� °���,_ ._._. � � �
<br /> Applicant s Signature: � �-v \1�-�— Date: � �
<br /> ,. .: _ .
<br /> �,._ F .
<br /> � .� , . _ ,.
<br /> ��T" .., . -�.�- ,.F;' ; . .� .
<br /> ��¢ �
<br /> �a. '� � �
<br /> .� � � ��
<br /> ��` ���';� ���� ����� ���� ���
<br /> ��r��`��,��"
<br /> :'t � �' �" ��`
<br /> � ' ,`
<br /> � , ' s��� ra���' �•
<br /> � � i �l., �k�'+��
<br /> , ,. ..
<br /> - ` • . , ���,� „�� ` _
<br /> �i �
<br /> , ' 3 3t� ,�
<br /> .
<br /> - �. � �� � - �. ,
<br /> x.� �.�• . r�� �
<br /> . r �,, .
<br /> �-
<br /> - <-�.. •` >�
<br /> , , ,
<br /> �� � �'.�.
<br /> ., � ,
<br /> _ �
<br /> ,�,-��--�. _
<br /> .
<br /> : .., ;,, -, ,��: '� ,+ _ -. ., a
<br /> : . , ��
<br /> t G� �y ` .c�
<br /> � r
<br /> �
<br /> . •� r�,'' - s ot'#a�h +��r ��r � _.. �a ,'�� :- �,�c. - '
<br /> s.. t� � , '.>�y x��,n`�?.- ,� ��y k.,,�°�"'�1E '�`agi ���7 U��C' #V^" t.� �+� r�, ����, w-a���' J ��'S
<br /> ., �. �aa t . � �t� ���:� � �r���� �v + ,� $`� "� � 4�� R '�'s�
<br /> r �,, '�,,..�
<br /> k^' f �.� d t.rrt �.;x�, ��� ���k �;��5k�'�, 1C�S� k."F� �?�3���.��:,;�� 3 ,-�-��. �.�z,-�� ,3°&��� ��_' x'�a }A�.ay.
<br /> ° ' � �,����4� j�F �� } � s>;�- � •sks '� � "�'"� �N,a.������3.� „��'� m' ,a ��'`����:te"�` -� � "y.j��C� i,�z�
<br /> .,,'�a,>, �..,. ? r�..r;�`� : t �>�' x 4 ;M �� '� �"�-�' ..;�" �'z ,;�:fi��' „'�`a� s.'�� r.s�y�„� xi` n r�,�,����zv ������h�"'� "nv, 4�,�}*'��.y�: �
<br /> �' �
<br /> . ,�' �':��x�, �� � d� .r ' ..v � : � .y ¥xf ;��` x �$�;} ��.��:�d� �''����i��'�t,j,r��x-� :�' �ti::3F ''_ka�,+�;GF�,'�.� 5�,'q���, ,�. y�,x
<br /> �.' ? Ics$'S�-a`'�. .. '� y �"?�g,.r �' z_� K�s�-:. , "a� 3�,�n �,. a � x � `S���$P",i�`.s��v
<br /> 'g �,?+� rd"�'"�' �s��4 � s x:, 4 'k t F , 7�. � �'+�'g P��t t,t �Q K-A,�� : ^t h-��: �` W � , � �f � ��r':,,���'F� `�n,
<br /> �` � ;��� ae ��t� r � 'rr'`�� �i 3y�'ti'' ya�+`T�s"f'y:' t � t`C<� k -��+ � ���'�'� `�r+s x±4 }'�"��
<br /> �. .� ,��Ft � + . a ;� k ,�. `^;� �,a`.,v�t f''"�� �-�a �'-„�,� ��� `s"',�. . ��,r'� ,�� -
<br /> fc,f 3n't�FY �, �.,,,.. y. �s £�, v � .'��`' _ ,+ �f na S .4 s.. ,..�,,. '�k. "�?�. �k �.Sa Y' R`*.,.. � i ,�,fi��Y::
<br /> � � � jr"� ¢{ x.#��v m-£i ��a F ` s� ' ,� �� ��,XA ;"'�.�,��'Fi.*"' �-z�a"�4�s{ � ��"»�f t M`z'"2 at `,�"�'. �t'"i�'^,���'y}'�" `�-�' ���g ;y�``"�.�g��.
<br /> -Ti p2n +t., ( . ,q�r ,: � N'� �¢� � .� �. "d,y.n ���_ l }�r t �.. '4` .iY'4.i. '6 {' �'i--•
<br /> � ty�'�.�� �._ � ,,t� ; .. � �' .��t - x ,� : X ,� ..,r �.�i� �¥�"'�, :-?� ��a�.;¢s�,�.x �1 3' ..
<br /> ." ° � ,�°s?t- ,�• t •sp 4-.�^ fv w :L�`1`�s�, ,;,,. ss y� ti '$ �� ., � -Sy,4 kt^3�;ai.K�f'�}s�,s ,�i� �V. :�,� a� _ �,r�,.
<br /> ,. .,� . � �.�'S,� k �R. ,�,i( `x 1.,, • . ��"�.F S" k'L�^ S 4.'�Sab�`.•£ ,pt stJ .r' }�, '� - :+�`,vCR�.:
<br /> ro
<br /> .�.e;� -�..�. ..2�4.�^.-.�T+..:-• .�',r1`kz..,.:. .M.S�-n.s.'�.r ",.r ,,., ;a ' :,_'z � ' _ ,.�:'.t�x.�e. '�� :;z w..., . .x.,�L,� r.. f`a��'Q,.�nc; x»-sP'�'�'. .�i � ,�,� _ .. ,. . a'".�:.:�:;i..
<br />
|