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- ..:�T� 3'��� � � � vci� } s�,a.-� �r'3�' ''S L �` �'�` '?��;�t F.A�x�iA°�' r �� '`''�' ��� � _"y��'+ .�' y k,_;. � :G <br /> .L.'*'y c�f� ,3�� �.`"1 ',�" 2 S�4 l '� g 'T£'� ;�rqh At . �4 �a» }� 'T +f�� � ° ��� <br /> �� � � � ��p +ak �. �� 4Z 'A ,� �.���." b�.fo y �,�`�w 'a-!� 'jT � �r� <br /> , ,. <br /> �- ,. <br /> + '.;. ,. ..mffi�Y�.�Kf����`'�'.�� :,:��q '�+, .,.. � .--��`��i�h:'s�.ila���3_.5;.-� ,�,. ..,����"�;'� r_a�.,i�� .. . {_ . ,�'�'� .,�. <br /> � <br /> . . .__ ..� y s <br /> � <br /> PERMIT FEE CALCULATION <br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.00) <br /> l �� x .0125 $ <br /> (contract price) <br /> 2. State Surcharge. ** Add the State Building Code Division <br /> � Surcharge to each permit. x .0005 $ <br /> (contract price) <br /> or $.50, whichever is greater <br /> 3. Postage and Handlin� (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ <br /> * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted <br /> work including materials, labor, profit, and other fixed costs. It is the amount to be charged to the <br /> customer for the work done. If any material, equipment, labor,or installation are furnished by the owner, <br /> tenant or any other party the reasonable market value of such items must be added to the estimated cost <br /> or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, <br /> the City may request the submission of a signed copy of the actual contract. <br /> ** The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is <br /> greater. For valuations over $1,000,000 call the Department of Inspectional Services for the price. <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all <br /> work in strict accordance with the ordinances of the Ciry and the regulations of the State of <br /> Minnesota, and certi�es that alI statements made on this application are complete, true and <br /> correct. <br /> � Applicant's Signature: ��.�.��cz/ � r��� Date: '�- !-9� <br /> ,i <br /> �,.*�t �x. . y r,�sa �. t a � s� � ++�j` ^:vi' re� x hg �� .�;. ��- - <br /> ,+.. <br /> �� � �> � � " �; k`�,� �� "a�� w �,�$�'� � � �» "� <br /> .�� � #.', ra �x � ., �,` ?�g � �, � h. : �,tc� �:yz� � ��,r+ <br /> .� "��� �`�F���S�ry�i� . �w' �� .u�& � +y,� ���t'��z���� '� ., �". <br /> � � � � <br /> � S �'�`� ��`��"��'�e�°'�F '� t� '��r� a���'�' ,��� �� <br /> '€��° �r�-` E ''c' � ��s .1� ¢fo��"�''�' � *s�. �;�g�i# .,y�y�"�v i3' s ti rt'��»�� �7 a; - <br /> µ, .X t�:. r . � � • - „a., �,�,� � � :;� �.. , <br /> � <br /> r.�a ,��,�,�#�`�,��'�� '�� ��i� � � y � .`�� ,��` �� : �.y�' a ' � �t ��,'� � � , �i ���' <br /> �,�.u-�w�.-�' �,k.*���+- ��' . � .��ga�}4 � .t� t� ,*« -« +�n=� ,�s,,r€��a���55 �+c �, � ��, � }��'�_ 3, y E� � � �- i <br /> � � � � t �x�"�''dt s � � '�' n s .; +ir .,'�.sK �t .,� � <br /> -+F�,g� '�J�f 4�" �t,�"�#�� . ...� ��;`,y �!'�����t+ a"a* ) � a v�� °� t p�:: `'�`�1A'�, " i <br /> s�r 'ai t u"��`p.�,,.'`� '�pa`1T'C.r"<1.y�+. :¢ ��+ �.��, s . � �.�,�`a.,•'�+� a�`��"A�Ytt�t.} + s��" :#. . '��'�^, ��'•k� '� �R �$� :s. <br /> ��.�'% y'� �y"��'y` ,`y ��,;'e�, � ��`'U�,{t�'t�yo��s��a: �� .�� 4<�s."6, ��w . � "�` :s � a <br /> w a�� <br /> ..,� �g,n„}���e..K � �,{ .� �.���"z� ,i� ���y r�� � " ^� �"��� � �:,� aA��'� �`��+ �s� ��:FFA °ft���.�'� bAn�}�+�`� Sz- <br /> -5. ��v'5�''�1'4'Y'q ,o •$�- � �' ��� ���Y ��i 1� � � �a� 4'� W: �" �e f+ J'� 2X� ,} ' � Xi d �4 L� ���� .�.�,y� ,� <br /> r . 2 - � {' !'� A ",�f t �ry -. M� . �*n,^ i In ��� � <br /> ",��#.,�, lr; r j'h + �.x { '{ ,�, .� �. x �'� ;� `S -�-3' µ�i�� '+E,� � s'" `S '¢f x r '13 . <br /> t�` �' � ,�e n.p y�� � �'< 4:se��w �� c��,r� s '�F L rk � � t `', 1 � ; . � :� �"���'� � �`` "" "°k.�" � `"x � �"�s. <br /> � � �, r � � g x,�;,y _ � ' � , � 't ,� a? � � .,�v 'q"r��r,�s'„P' � �t r�� �'C i k�a. �t r �"4!, <br /> � t � � � � �'! ��i �x i <br /> � .s� .: t� < a r t� � . .� �� y§r:e c � _ f`kt"},- ..p 9 �� 3 ' ' <br /> Y ' h ,,T 4 `R�. �� �.x, � � S-� x �. fi ' A �Y : <br /> r : <br /> L8 `� � f'� �a: .r. { r ,,�� � �- *"5" 't",�- ;�� _; �, r -e <br /> � 4� s� t c. s.+ �` s .t ° x* <br /> .,, <br /> � _ a � � <br /> G - <br /> � <br /> ..„ <br /> F ._ - , .: .. � . ��.: .. . �;... , . . . � . � . ..' . . :�_.. .��, , _. . <br /> �, . r� , -�.. .. ,, .. . . . .��..., � �. . . -,- - : ... ..� ... , -i ..,. .'. <br /> F. .. � . . � . .. . � � � <br /> - , , <br /> � <br /> � •� <br /> ! .. . . , . . . ` . . ,. -; ' . <br /> ( .i'�,. ..� . . . '..� ..� �y . �M1 <br /> t . ' . . , .'" . . . . ' � .:� . ' ` . , .. '.�. ., <br /> i� .. �. ' . . . . .:" ��..� , �:' .'.;: . .." � . -� ��� <br /> ,`.. <br /> i ` ,�: . . . .. � , . . � . '' -� ., � � . � . � � . . . ����. . �� • .�. .. ., ' ,2�� ..� s.�. <br />