Laserfiche WebLink
07-21 a4 12:10 WAYNE DRUWALTER PLB� T:4484763 P:02 <br /> PeRMIT FEE CALCULATION�b',� <br /> 'l� State S�tute ❑ Yes, This Section Applies <br /> 7'lte �repl�tcement of a eSidential �xh,re or a liance that meets a11 three of the following requirementS; <br /> 1) D���quire mc�di6cation to electr�cal or�s service, <br /> 2) tias a io�• cost of �500.00 or Iess; excludir�� the cost oi the fixture or applia�nce: au�d <br /> 3) ls imNroved, installed or repiaced by ttie humeowner or licenced contractor_ <br /> Skip next sectinn; Cost of Permit $ �5,p <br /> Sta1c Surcharge $ .50 <br /> Mail In f'ee $ 1.50 <br /> 1(abc►ve does not apply, tollow g�iidelirtes below: <br /> 1. Conlract Price• is .0 125 '�of job with a Minintum Fee pf �$35.001 <br /> �' ���bq• I� x .oias � �c� .3�'�'� <br /> (�'�:mlrix;l price) (minintum$35.0f1) <br /> 2. St�te Sur'chSrQ►e. "•Add th�e State Eiuilding Code Divisiuii a (Minimum Ree of$ .50) <br /> �__��.1� x .UUUS $ 2-2�� ' � <br /> � � <br /> (comraci pricc) (minhnutn�.50) <br /> � ,�.�� �°� <br /> 3. Posta�gnd Handlin,y (()�i1y mail-in applications) $ 1,50 � <br /> �'" ' ' S�'� , <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ (op _ , <br /> * C;(.)N'f'bit1C1' P�lICf•, rx�I)t3 C:US'1' me�ns fhe saclus►I ur estimuled dollAr Ftmounl cha[Rcd for lhe pe�cxqilted work <br /> incluctin�moterialg, I�l.x.�r, proGl, and nlhet flxec� a>�ts. 11 iti Ihe art�ount lu be chsir�ed tu the cust�m�►er For the w�irk <br /> done. IF any malc�rial, equip►�i�ni, lafx�r, or inslallatl�n arc furnishecl by tlic �wncr, lentu►t or arty uthet parly ll�c <br /> rcl,�,ne,t,tc mtvkel valu< <�f such ifeu�s �i�u,! bc: aclelecl lu Ihe eFtirru�tod �x�s1 ur c�mt�aCt priCe for perm�t fEe <br /> purposes. lu tr��� �:v�l Ihtd lhere is � dispute un lhe arm►unt qf ihe jub uisl, thc (;ily may reyucst Ihe submission <br /> uf n siKnc:d cc�py af lhc z�t►wl cunlrtx;t. <br /> "'• The STATF. SItRGI[AiCt;r is _I,1(.)U5 u[ ihe mntract price under $l,onn,(1(.1Q ur $.50-whiehever is greater. <br /> P��r v�ilutalfuns uv�r��,1x)U,OVO CWl the lk�raftmc;nf 4f Ins�ecliun tii�rvitxs for Ihe price. <br /> Tlie uuder5igned hereby applies to the City for issuance of a Plumbing f'�rmit, agrees to do all work <br /> in strict accordance with tl�e ordinances of the City and the regulations of the State of Min�nesota, and <br /> certifics that aU statemcuts rnade on tb�s application are complete, true and correct. <br /> Applicant's Signatu � Uate: �- �� <br /> Reset Fonn <br />