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Ncv-16-20�2 GB:1Bam From-CITY OF ORONO +p622qpa616 T-t6E P.003/003 F-155 <br /> A O <br /> 200 State Statu�� ❑,Yes, This Secdon Apglies <br /> The replacement of a �tcsid�ntial fixnire or a�plianc� that meets all three of the fotlowing <br /> rcquirements: <br /> 1) �Q�34S roquixe modific��a to elecuical or gas service. <br /> 2) Has a eo t of$500.¢�'�less; clu 'n the cost of che f"ixnzre or applia.ncc: <br /> . <br /> and � � <br /> 3} Is improved, inst�ed or replacc�b� thc homeowner or licenc�i contractor. <br /> i� •� <br /> Skip next ction; `� Cost of Pertnii $ 15.00 _— <br /> State Surcharge $ .50 _ <br /> �! ia�Fec $ 1.s4 <br /> Yf above does not apply, follow guidelines bclow: <br /> 1, ntra �g* is .0125 $b 4f job with a Minimum Fee of(S3S.00) <br /> � � <br /> �1 �;,�L`__� x .012s $ �e��7; � _ <br /> (conu�aa price) C��53s.00) <br /> 2, �tate S�har� *# Add the State Building Code Divisioa a (lbiinimum Fee of$ .SO) <br /> � � <br /> � ��](_�? X .0005 $ L� � <br /> {coatract ptice) {minimum S .5�) <br /> g, p����d���,� (Only mail-in applicat�ons) $ _ '�'� <br /> 4. TpTAY,PER,'YII'T FEE (Add lincs 1-3 above) $ �(`)`� � �'L <br /> « �a�p�p�C�or JOB COST mesa�the aetual or estim�ted dollar awoun�char;ed foz thc permitted <br /> work irxludir�materials,l�bor,proflt,�nd o�er flxed costs. It is th�amaunt to be c�arged to the cusmme� <br /> fCz�yyQT��r ap: Tf�y�t��i�,J, �qRqgmeent, labor,or iasiallatian ase fi�raished by the owner; tensat or <br /> �y�eX pa�ry chc reasonablc market vtllu�of such itea�s must ba added to tkie escimared cost or conuact <br /> price for pennit fa purposes. In the event that�here la a dispuu oa the amoum of tht job eost,thc Ciry may <br /> zequw�the sabsuiasion oi�ai�ned copy of�e ac�ual contract. <br /> ** 'I'he STA7E SURCHARGE is .00aS of the contraet price under$1,000,000 or �.50-whic�ever is�eater. <br /> For valuatioiu over 31,000,000 csll me DeParament of Inspectian 3ervicea for nc�pri�e. <br /> The uadezsi�d her�by applits to the City for issuance of a Plumbing Perm�, agre�s to do all <br /> work in strict acr.ordance with tha ordinancrs of the City and the regulations of the St�ce of <br /> Minaesota, and certifies thnt A11 stacements madc on this applicadon are camplete, true aad <br /> correct. <br /> __ � Date:/��� ��1 <br /> Applu�ut's Sig�sauu�_/ )i l�h�����7]£�../� <br />