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:3�i-i3••2J04 09:;i�rt Franr:l"` OF OP,ONG +9s224eE616 <br /> T-642 P )03/003 F-60� . <br /> Y�R�u'T'_F'F:E CA,�,CL��.�.��o� <br /> �OQ2 State r e � �'es, This Sectian Applies <br /> The replacement of a R�sideritial �xtur� or ap�li• nce that�meecs ail three of t2:e foilowing <br /> requiremtnts� <br /> 1 j , ��e not require modification to electrical or gas service. <br /> 2) Eias a t t� cos of.�',:50U.00 or less; g�i�d� the cost of the fixcure or appliance: <br /> and <br /> :i) Ts improved, installed or rcpla�ed by the homeo�x�n�r or licer�ced contracCor. <br /> Skip nexr section; C�;t o;Permit � _ 15.00 <br /> Sta�e Surcharge $ .SO <br /> Mail In Fee � ---- 1,�0 <br /> If above does not apply, Tollow guidelines below: <br /> 1. CQn ac�Yrice�` is .0125 % of job with a :1�Iinimum ee of �.00 <br /> �� '�':- '� �)C� x .0125 $ _ -, _ <br /> -�-,-=-� - .— -�_.r.::�s:� <br /> (contrac; pnce) (rni�imum 535.UU) <br /> :.. State Surchar�e. '`* Add thc Scate Building Code Division a (Minimwn Fee of$ .501 <br /> _�:���������������� x .000s � �' ��;�� > <br /> (contract nce) -�--- .r` , : ��. ...,r.— <br /> P .minimum S .SG? <br /> 3. Post,�e and I-Ianc�l� �OnIy mail-in applicatiors) $ _ 1 SO _ <br /> 4. T01'AT. PER'�tIT FEL (Add lines 1•3 above} S �?�, -���'`;: <br /> -_--�-� ,�.,�: <br /> ` �e�N7RACT PR10E er JOB CUS"!' mcans t};� acrsai or estunatrd do:la� amount charged for dit permitted <br /> :�ork includm�mauria;s, labor, profit,zr.d ocher fixed cos�s. IT is�he amount io be charged to the cus:ome: <br /> for thc work done. If any ma;er;al, equipmzr.t, lab4r,or inscaUation atz furnis(ud by thc owner, tenant or <br /> ��y ochcr pam che reasonable marke� va]ue of such items must be added to tht estimat�d cosr or conrract <br /> ptict for peiniit fee puryoses. In t,`��e�ent tha� il:ere is a dispute c>n chc amount of he job cost, t,�Ciry r,iay <br /> r�quest :be subaussiori of a si�ied co��ot'tre actual contract. <br /> " 1'he S"CATE SL'RCH�RGE is .0005 0:'che contract prue t:xder$1,000,000 oc 5.50 - whichever ls greatec <br /> For vaJuarions over$1,000,C00 cal] the Depa�cmcat of lnsp�ct:cn Ser;ices foT cht price. <br /> 7'he unclersigned hercby applies to thc City for issuance of a Plumbing P�rmit, agrees to do a!1 <br /> work in stsict accordance with the ordinances of �he City and the reguiations of the State of <br /> Minnesoca, and certifies chat all staterrencs �ade on this app;ication are complete, true and <br /> correct. <br /> /, /', <br /> . . . -, <br /> Applicant's Signacurr. . � �-� <br /> ----���`-�---` ' _ -- .__.._ Dace; -' ^�5= ��, <br /> �..fr <br />