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J�n-2R-�Op2 1��5dpm, . Frnm-fITY �F �R�NQ._..... _... _ .. ... _.._._ +A5��dAdF1F T-FFB---p_nD5�nn5 F-QF1 --- <br /> . <br /> pE 'IIT FEE ALC ATY S <br /> 20Q2 Sta e Sta te ❑ Yes, This Se�t:ion Applies <br /> The replacement of a Residential fixture �r appl'•ance thac meets aIl three o�' the fo]I�wing <br /> requiremencs: <br /> 1} Does no requir� modi#ication to electrital or gas service. <br /> 2) I-�as a tota_ 1 Cost of$SOO,QO ox l�ss; exch:�iin� the cost of the fixtuxe or appliance: <br /> a�d <br /> 3 j Is improved, installed or repiac�ed by the homeow'ner ur licenc�d coniractor. <br /> Skip next seciion; Cost of Perntii $ 1 S.00 <br /> State Surcharge �a .50 <br /> Mail Tn Fee $ 1.SO <br /> If�bove does noc apply, follow guidelines heluw: <br /> l, Contr� t PriCe* is .0�.25 % of job w�ih a Minimum Fee of�35.00�, <br /> - �,� x .0125 $ �/0: �� o <br /> (co tracv price) {miramum�35.00) <br /> 2. Slate S�r_char�e• �`� Add the State Builriing Code Division a (�Iinimum Fee of$ .5D) <br /> x .0005 $ % ' `� <br /> (concracc p�'ice) tminunum$ .50) <br /> 3. Po ta�e nd Hanrllir►g (Only rnail-in applications) $ 1.50 <br /> 4 �qTpL pEg;tiIYT FEE (.Add lines 1-3 �bave) $ <br /> � Z, �� � <br /> * CON'CRAC'f PRIC�or JoB COST means d�e acival or esticnat�d dollar arsuant charged for the perrsitted <br /> work includ'uy;macerials,la�or,pro�ic,and other fixed eosts. h is r1�e amaunt to be chargecl to ttie eustemer <br /> far the work done� Tf any material,equipm�:nt, i�b�r, or msiallation are furnished by t�e owner,tenant or <br /> any other party trie reasonable market value of su�h items m�st be added to the escimated cost or coacract <br /> price for permit fee purposes. In�he even:tha�t�,erc is a dispute on the amount of the job cosc, �he City may <br /> request the subzr+iss:on af a signed copy of U�e actuaI contract. <br /> �� Th�STATE SURCHARci�is .00�`_of ttu:e�n�ract price under Sl,O�O,OGO or $.SO -whichevcr is greater. <br /> Por valuations over $1,000,000 call the Depanmznc ef I:�spection Services for the Qriee. <br /> The undersigned hereby applxes to the City far issuance of a Plumbing PernuY, agrees to do all <br /> work in strict a�ccorda.nce with the ordinances ot the �iry and �.he regulations of the State of <br /> Ivlinnesota, and certifies that alI statement� mad� an this application are complete, true and <br /> correct. <br /> � � � , �-� � ���� <br /> Applicant's Signature: � � � Date: � — Z __ <br />