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, � <br /> PERNiYT F�E CALCY3I,ATTON(Sl <br /> 20 2 State Statute � Yes, This Section Applies <br /> The replacemeni of a Residential f xture or appliance that meets all three of the following <br /> requirements: <br /> 1) Does not require modification 1.o electrical or das service. <br /> 2) Has a total cost af$500.00 or less; excludinQ the cost of the fixture or appliance: <br /> and <br /> 3) Is improved, installed or replaced by the homeowner or licence� contractor. <br /> Skip next secuon; Cost of Permit $ T5.00 <br /> � State Surcharge $ .S� <br /> Mail Tn Fee $ 1.50 <br /> If above does not apply, follow guidelines below: <br /> 1. Contract price* is .0125 % of job with a NTinimum Fee of ($35.00� <br /> x .0125 $ <br /> (canir;ict price) �minimum$35.00) <br /> 2, State Surcharge. *�` Add the State Building Code Division a (IViinimum �'ee of $ .50) <br /> x ,0005 $ � <br /> (conU�act price) (minimum$ .50) <br /> 3, Post��e and I�andling (Only mail-in applicarions) $ 1_50 <br /> 4. TOTA�. PERI�IIT F'�� (Add lines 1-3 above) $ <br /> * CONTF.ACT PRICE or 10S COST means thE:actual or esrima�ed dollar amoun�charged for the germicted <br /> work includiq,materiais, labor,profit, and od�er fixed costs. Tt is rhe amount[o be charged to the customer <br /> for the work done. If any material, equipmer�t, labor, or installation are furnished by the owner, tenan�or <br /> any other parry th�reasonable market value cf such i[ems must be added to the estimated cost or contrac� <br /> � priee for permi�fee purposes. In the event thac there is a dispute on che amount of the job eost, the Ciry may <br /> request the submission of a signed copy ot thr. actual contract. <br /> ** The 5T'ATE SURCHARG�is .0005 of the contract price tinder 51,000,000 or S.50 -whichever is greacer. <br /> For valuations over�1,000,000 call the DepaRmen�of Easpection Services for the price. . <br /> The undersigned hereby applies to the City f��r issuance of a Plumbing Permit, agrees io do all <br /> work in strict accordance with the ardinanc�:s of the City and the regulations of the State of <br /> Minnesota, and certifies that all stacements made on this application are complete, true and <br /> correct. I � <br /> Applicant's Sinnature: �-- �Z �� �.�:1.0 � �' l� �_.� Date: -�}� Z� -�C�� <br />