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/ hrv-16-2002 CB:18�m From-CITY OF ORONO �06224C4616 T-<"E P.003/003 F-155 <br /> . j \ <br /> AT O �i, �(� <br /> �p���g��g ❑ Yes, Thfs Secdon AppUes <br /> / <br /> The replacement of a i n ' 1 f' tbat meets all three of the following <br /> rcquiremeuts: <br /> 1) �.�X�t roquixe modificati elecuical or gas service. <br /> 2) Has a cost of$500.00 1 ; Clu i tLe cost of the fixture or appliancc: <br /> and �`� <br /> 3} IS improved, installed o replaccd b�thc homeawner or licenc�i coatractor. <br /> Skip next section; �� Cast of Permi� $ 15.00 <br /> j State Surcharge $ .50 _ <br /> � MaiI I�Fee $ '.S�J <br /> �f above does not apply. follow guidelines below: <br /> 1. CantraCk��* is ,0125 °k of}ob with a 'nimum Fee of(S►3S.00) <br /> � � � � <br /> '��,C7�� x .o12s $ ����'� <br /> (conmict prise) C�535.00) <br /> 2, �* Add the State Building Coda Divisi4n a (M�nimtun Fee of$ .54) <br /> �� �� 5� <br /> � c�:� x .OG05 � , � <br /> , <br /> (cantract price> (minincum S .so) <br /> 3, p� (On1y mail-in applications) $ _ <br /> 4. T'pTqY,PER'YII'T FEE (Add lines 1-3 above) $ `�r ��C�; <br /> � CpIVTRACT PRYCE or J�B COST uieans the Actua]or estia�zsed dollar amounc charwed Par thc gcrmined <br /> work includir�mt�rials,labor,proflt,snQ o�er flxed costs. It is th�amount to bo c'_iarged to the cus:omer <br /> for tbt wUrk done, If z�ty�tt::z.�,eY ip�n:, 'a ..r,�r inssa�ladcn�se furaished�y the owner, tenanc or <br /> �ay othex pa►ry cht reasonablc markot vAluc of such items must ba added to the estimaced cost or contrae[ <br /> prta tor peRnit fa purposes, In the event that there ta a dispu�e on th�e nmouni of the jab cost,the Ciry may <br /> requesc shc sabminsion of A ei�ned copy of�e actual eomtracc. <br /> ** 'Y'he STA7'E SURCHARGE is .00DS of the coAtraet price uader$1,000,000 ar $.50-whic�ever is greater. <br /> For va]uador►s over SI,ODo,000 call tl�e De.parcneati of lncpeccion 3ervices for die price. <br /> The undersi�ed hertby applies to thc City for issuance of a Ptumbing Pernut, agrees to do all <br /> work in strict Acr.ordance with the ordinanccs of the City a�d the regulations of the Stace of <br /> Iviumcsota, and c�rtifies that all steternents madc on this applicadon are complete, true and <br /> correct. <br /> � ��tict_, ��.-�.c� Date: ��' � �a <br /> Applicant'sSignan� .�� — <br />