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04/18/2013 18:45 FAX 7634775629 f�007/OOS <br />. , '. � <br /> If aboue does not spply;follow�uidGlines belo�r. I <br /> ' 1. sO�CT P,$L 'is 1.25%of aontxa�ct prica with a(Min�mum Fae ot'550.00) <br /> �, x.fl125$,,,�u <br /> ���� (miul�rum S.So.90) <br /> ' Z. STATE 51�IRCHARGE � I <br /> ���x.0045 $ � <br /> � <conlrflCt Pl�Ce) <br /> 3. POSTACrE l�HAN1�L�[NG(Only on Mail-ln Applications) $ � 0 <br /> 4. TOTAL PERMIT FEE(AddLine�1-3 Above) s r <br /> ■ *�CONTTtACT P'RLC� or JOB COST means the actual or e�hmated dallar amottnt ahar'Sed f the <br /> p�smitt,ed work including mate�ials.labor,profi�and ottter Fixed cosTs. It is tlte anwunt bo be �ed <br /> fi,the custamar for ti�e worlc don� If any mateQial,equipunemt,labor aa installa6ans are � bY <br /> th,e owner,tenant or ar�y other party,the rEasonable market valuc of such items must be added the <br /> e�timated oost or contrac�t price for �t fee purposes. jn tne e�'�rt t�at tha'e is a dispute the <br /> a�ount of the job cost, the City may requast tfie submission of a signed copy of the actual ca� � <br /> The undersigned h0reby applies to the City for issuance oF a Plurnbing Pennit, agress to do all <br /> work �in strict a�ccordance With d�e of'dinances of the City and the a'egulatians of t�e Sta of <br /> Mirm�,sota, and certafies that all staxtments made on this application �re complete, �ue�nd <br /> c�. <br /> � �� -r <br /> Appli¢ant's Si D�' <br /> II�, I <br /> 3 <br /> I�� II <br />