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03/07/2017 TUE 1a:�3 FAx 763 d73 8565 Ssbre xeating 6 Air Cond �OOa/OOa <br /> If above does not apply;follow guidelines below: <br /> 1. �ONTRACT PRIC� *is I,25%of contract price with a(Minimum Fee af 550.0(1) <br /> _ _�35o•bQ �.oizs� 5ano _ <br /> (COtlCrhot�)fiCb) (htiuimum$SO.pp) <br /> 2. TA CAARGr�,' <br /> �S)�.___x.0005 5�..___!� <br /> . (contraot price) <br /> 3. pOSTAGE&HANDLING(Only on Mail-In Applications) S_ 2,00 <br /> 4. TQ'�AL PE�IVIIT FEE(Add Lines 1-3 Abovo) S '�'��.(p�j' ,_�,�, <br /> � '" CON'�'J.tACT PRYCL or 70B COST meac�s the aetual or estimated dollar amount charged �or the <br /> permitted work including materials,labor,profit,and other fxed costs. �t is the anc�ount to bo char�ed <br /> � to tho cus�mer for t�e work done_ if any material,equipment,labor or installati�a are furuished by <br /> I the owner,tenant or auy other party,tlie reasonablc markct vafue of such itmna must be added to the <br /> eetimated eost or contruct price fot pont►it fee pwposea, In the event that there is a dispul�e on the <br /> � am0unt o�F the job eos�,the City may request the submiasian af a signed copy of the aetve,l co�mract <br /> 'l�c unde�rsigned hereby applios to the City for issuecuce of a Plumbing Permit, agi�s to do a11 <br /> work in sirict accordance widi the ordinan.ces of the City aud the regulations of the StaLe of <br /> Minnesot� and certif'ies that a11 stateqsetxts made on this application are complet,e, true and <br /> correct, <br /> Applicant'sSignature: � � Date: �•�� ���] �_ <br /> � <br /> 3 <br />