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05/13/2015 12:25 F�X 95293�5049 CULLIGAN MNTKA �004
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<br /> If above does not apply;fofIow guidclines below: ` '
<br /> 1. CONTR.4C7"1'RICE *is 1.25%of contrftCt price�vlth a(Minimum Fec of$50.00)
<br /> x.0125�
<br /> (CUn[Tac�pric�) (minimum$50.D0)
<br /> 2, STATE SCJRCAARGE ** Add thc State Bldg Code Div.Surcharge(NZiniroum Fec oT55.00)
<br /> x.0005 $
<br /> (con�ract pricc) (minimum 5 5.00)
<br /> 3. P05TAGE&HANDLING(Qnly on Mail-In ApplicaYions) $ 2.00
<br /> ct. TOTA►1�PERMTT FEE(Add Lincs 1-3 Abave) $_ � �' �p
<br /> ■ �` CONTRACT PRICE or JOB COST means the actual or estimatcd dollar amount charged for thc
<br /> permitted work including materials, labor,profli,a��d other fixed cosu. Jt is the amounc to be charged
<br /> tp the customer for�he work done. If any material, equipment, Iabor or instAflations 3re fumished by
<br /> the owner,tenant or any other party, thc reasonable market value of such items must he added to the
<br /> estimated cost oC Contract pi'lce for pe�mit fcc purposes. In the evenS that therc is a dispute on the
<br /> amount of the job cost,the Giiy may requ�st the submission of a signed copy of the aetival contraet.
<br /> ■ **The S7'ATE SURCHARGE is.0005 of the contract prico under$1,000,000 or$5.00—whichever is
<br /> greater. �or valuptions ovcr$1,000,000 call thc Building Dcpar[ment at(9�2)249-4600 for tlte price.
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<br /> The undersigried hereby applies to the City for issuance of a Plumbing PernZit, agrees To do all
<br /> wozk in strict aceordance with the ordinances of ti�e City and the regulations of the State of .
<br /> Minnesota, and cenifies that a[I statements marle on this application are complete, true and
<br /> correct.
<br /> A.pplicant's SignAture: Date: �- �� ^�
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