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Ju1-16-2003 D7:38an From-CITY OF OR01� +A522484616 T-837 P 002/002 F-972 <br /> pE� � CA�.CULA ION <br /> 2002 �tate Statute � Yes, This Section Applies <br /> The replacemenc or a Re�idential fixture or �ppliar�ce that meecs all threa �f che following <br /> requirements: <br /> 1) Does not require modi'�ication to electrical or gas service. <br /> 2) Has a total cost of$500.00 or less; excludin�the cost of the fixwre or appliance: <br /> and <br /> 3) Is improved, installed or replaced by the homeowner or licenced concractor. <br /> Skip next section; Cost of Permit $ _00 <br /> State Surcharge $ .5� <br /> Mail In �ee $ 1.50 <br /> If above does noc apply, follow guidelines below: <br /> 1, Con act r'rce* is .0125 °I of job with a Minimum Fee 4f($35.00) <br /> °� x .0125 $ � � �� <br /> (contract price) (minimum$35.00) <br /> 2, �ta�Surc�ar e ** Add che State Buildins Code pivision a (Minimum Fee of$ .50) <br /> � —I -� <br /> �� x .0005 $ � I�7_ <br /> (contract grice) (minimum� .50) <br /> 3, po��e an Han�g (�r►1y mail-in applications) $ 1.50 <br /> 4. TOTA.L PERMIT FEE (Add lines I-3 ahove) � � � <br /> * CONTItACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitued <br /> work includi�ig materials,labor,profit,assd other fixed costs. Tt is the amount to be charged�o�he customcr <br /> for the work done. If any mauri2�1,e�ipment,labor,or instailation are furnished by�he owner,tenant or <br /> any o[her pa�'ry tha reasonable mazke�valtye of such items must be added te[he estimated cvst or eonvac[ <br /> price for p�rmit fee purpoces. In ihe cvent tt�at there is a disgute oa che amoun�af[he job cost,ihe Ciry may <br /> reques�the submission of a signed copy of the acn�al contraet. <br /> ** The STATE SURCHARGE is .OWS of che eonuacc price under$1,000,000 or $.50-whichever is grea[er• <br /> For valuations over$1.000,000 cali che DePar�ment af Incpec[ion Services for ttie priee. <br /> The u�ersigned hereby applies io the City for issuance of a Plumbing Permit, agrees to do all <br /> work in strict accordance with the ordinances of the City and the regufations of the Stace of <br /> Iirlinnesota, and certifies that all statements roade on thi a plication are complete, true and <br /> coaect. � <br /> . � , <br /> ,-�/ � / . �. <br /> ,.� <br /> � c►�t.vv�.� ! L �;��. -�R Date: <br /> Applicant's Signacure: �, <br /> ; <br /> L � l� �� <br />