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PERMIT E CALCYJ'T,ATION S <br /> 20 2 State Statute Yes, This Sec�tion Applies <br /> The replacement of a �2esidential f xture or appliance that meeu all three of the following <br /> requirements: <br /> 1) Does not require modification t.o electrical or gas service. <br /> 2) Has a total cost of$500.00 or less; excludina the cost of the fxture or appliance: <br /> and <br /> 3) Is improved, installed or replaced by the homeowner or licenced contractor. <br /> Skip next secuon; Cost of Permit � r5.00 <br /> � State Surcharge $ .SO <br /> Mail Tn �ee $ 1.50 <br /> If above does not apply, follow guidelines below: <br /> 1. �ontract �'ri�e* is .0125 � of job with a 11�Iinirrtum Fee of ($35.0�) <br /> x .0125 $ " <br /> (caatr,ict price) (minimum$35.00) <br /> 2. State urcharge. *�` Add the State Building Code Division a (1Vlinimum Fee of $ .50) <br /> x .0005 $ ---- � <br /> (cono•act price) (minimum $ ,�0) <br /> 3, Posta�e and Handling (Qnly mail-in applicarions) � 1.50 <br /> 4. TOTAY. PER'�IIT F�E (Add lines 1-3 above) $ � �. � __ <br /> * CONTF'.ACT PRIC�or JOB COST means the actual or es�ima�ed dollar amounc charged for the germitted <br /> work inciudic�materials, labor,profit, and odier fixed costs. It is rhe amount to be eharged to rhe eustomer <br /> for the work done. If any material, �'C�l22PIT1�'Il[, labor, or installation are furnished i�y the owner, LEII3IIL Of <br /> any other parry the reasonable rnarket value af such i[ems must be added to the estimated cost or contract <br /> price for permic fee purposes. In the avent r.hac there is a dispate on the amounc of the job cost, the Ciry may <br /> request the submission of a signed copy of thc actual con[ract. <br /> ** The STATE SURCHARGE is .0005 of the coi��ract price under 51,OOO,Q00 or S.50 -whichever is grea�er. <br /> For vaIuaiions over�1,000,000 call the Depacrmen�of Inspection Services for the price. <br /> The undersigned hereby applies to the City fi�r issuance of a Plumbing Pemlit, agrees to do all <br /> work in strici accordance with the ordinana:s of the City and the regulations of the State of <br /> Minnesota, and certifies that all stacements made on this application are eomplete, true and <br /> correct. <br /> Applicant's Signature;���L�� . � Date: �_� <br />