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PERNTIT E CALCUT,ATTON 5 r <br /> 20 2 State Statute �Yes, This Section Applies <br /> The replacement of a �tesidential f xture or appliance that meets alI three of the followin� <br /> requirements: <br /> 1) Does not require modifica�ion t.o electrical or das service. <br /> 2) Has a cotal cost of$SOO.OQ or less; excl�din� the cost of the fxture or appliance: <br /> and <br /> 3) Is improved, installed or replaced hy the homeowner or licenced contractor. <br /> Skip next secuon; Cost of Permit $ T5.00 <br /> State Surcharge $ .SO <br /> 1_V�ai? Yr_ Fee S 1.SQ <br /> �f above does not apply, follow guidelines below: <br /> 1. C�ntract Fri�e* is .0125 I of job with a Minimum Fee of ($35.00) <br /> x .0125 � <br /> (contr;zct price) (minimum$35.00) <br /> 2. State Surcharge. *�` Add the State Building Code Division a ('iViinimum Fee of $ .50) <br /> x .0005 $ � <br /> (conu�act price) (minimum� .�0) <br /> 3. Posta�e and HandlinQ (Qnly mail-in applications) � 1.50 <br /> 4. TOTAL PEl.t.1'IIT F�E (Add lines 1-3 above) $ <br /> * CONTRACT PRICE or JOB COST means the actual or estimaced dollar amounc eharged for [he permitted <br /> work zncludiq,materials, labor,profic, and odier fixed costs. It is che amount to be eharged to che eustomer <br /> for the work done. If any material, equipment, labor, or installation are furnished by the owner, tenant or <br /> any other party th� reasonable snarket value cf such i[ems must be added to ttie estimated cost or contrac[ <br /> price for permi[fee purposes. In the avent tha�there is a dispute on the amoun[of the job cost, the Ciry may <br /> request the submission of a signed copyo uf thc actual contract. <br /> ** The STATB SURCHARG�is .0005 of the coiitract price under S1,000,000 ar 5.50 -whichever is greacer. <br /> For vaIuations over 51,000,000 call ttte Deparrmen�of Inspection Services for the price. <br /> The undersigned hereby applies to the City fi�r issuance of a Plumbing Pemut, agrees to do all <br /> work in strici accordance with the ordinanc�: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 /> A licant's Sianature� � � � �� Date: ' � �—��� <br /> r� n .��-o r � <br />