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63/07f2605 10:49 6513651457 JANECKV PLUMBING PAGE 03 <br /> � ti <br /> �ERMIT TEE�ALCULATION 3,5, ('� (� <br /> 1. 1.25� of Contzact Price* or ' imum Fee 0 <br /> ;Z / 0 o x .0125 $ <br /> (contract ptice) <br /> 2. State SurcharQc. ** Add the State Building Code Division <br /> Surcharge to eac� permit. x .0005 $ • �� . <br /> . (contract ptice) � <br /> or $.50, wbichever is gzeater <br /> 3, Postage and Handlin� (Only mail-in ap�lication�s) $ <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ (o,�� <br /> �, - <br /> * CONTRACT PRICE or JOB COST means the accua] or estimated dollar amouttt charged for the permitCed <br /> wo��C including materials, labor, profit, and oth�r futed costs, It is the ar�ount to be charged to the <br /> � customer Forthe work done. If aa�material, equipment, Iabv�;��--�ASEallation,are furnished by the own.er, .. <br /> te�qant or any othe�c party the reaso�pable market value o;f such items must be added to the esci�nated cost <br /> or contract price for permit fee puiposes. I;R the event that theie is a dispute on tbe at�aount of the�ob cost, <br /> the Ciiy may re.�uest the submission of a sig�ed copy of the acmal contract. <br /> ** 'l�,e STATE SURCHARGE is .0005 of the coAt�tact price under $1,000,000 or $.50 - whichever is <br /> gz�eater. For valuations over $�,000,000 call the Department of Tnspectional Services for tb.e �rice. <br /> The undersigned h�reby applies to the City for assuance of a Plumbzng Permit, agxees to do all <br /> woxk in stricc accordance wxth the ord�nces of ihe City and the regulations of the State of <br /> Mizuiesota, and certifies that all statements made oz� this applicacion are comp�ete, true and <br /> cor�ect. <br /> i <br /> ; .A.pplicant's Signature: � Date:,3' 7� �.� <br />