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� @ov-18-2002 u8:18am Prom-CITY OF ORONO +D822494616 T-45@ P.003/003 F-136 <br /> � � <br /> PE'L��'IIT ��CA��_ATIQ�� <br /> 2002 State �� � ❑ Yes, This Se�ction Appl9es <br /> The reglacement of a �t.esi tial f'vc � ' c that meets all three of the foilowing <br /> rcquirements: ` <br /> 1) �,� reqvixe m ' ic on to elecuical or gas service, <br /> 2) Has a cost of$5 . or less; clu in the cost of the fixture or appliancc: <br /> and <br /> 3� Is urtproved, ins ed ox �e Iaced b� thc homeowner or licenced contractor. <br /> Skip next sec 'on; Cast of Permii $ 15-00 <br /> State Surch�r�e $ .SO _ <br /> Mail In Fe� $ 1.50 <br /> Yf above does not apply> fallow guidelines below: <br /> 1, Cpntraet�'�* is ,0125 4b of job with a Minimurn Fee uf�$35.00) <br /> � <br /> /� 5C`()�` x .0125 $ I�'��� •�`� <br /> (contraCt price) (minimum$35.00) <br /> 2, Stat S • l�a *� Add the State Building Cad� 17ivisian a (IYl�nimuzn Fee af$ .50) <br /> /���'` _ x ,0005 � � ���� <br /> (contract prict) {����� ,��) <br /> �, p,� (Only mail-in epplicatiorns) � _ <br /> 4, TpTAY.F�RMIT FEE (Add lines 1-3 above) � ��� r� <br /> * CON1'RACT'PR1C�nr JQB COST means the actual or estimated dallar amounc char;ed Por thc gcrm'st�ed <br /> wark includ'u►g m�terials,labor,profit,and o�.�r fixed costs. It is tht amount to be c.'�arged ta the cusromac <br /> for the work Clone. 1i Aay ma�erial, cquip�ent,:a�r,or�usca::atEc:,&re�1rnishad by th�awner, :enailt or <br /> �y a�x pa�ry che reasonable markot value of sueh itea�s must ba added tv the esumaced cosc ar eonuact <br /> price for penuit fee puxpases. In the event that[here ta a dispuie on th�amounti of tht jab casc,the Ciry mAy <br /> requesc the siabmission ot'a si�ned copy of The acnxal contract. <br /> *rt 'I'he STA7E SURCHARGE is .0005 of the contraet prica uader$1,Q00,00o gr $.50-whict:evcr is greacer, <br /> �or valuasions over$1,00�,�00 call tbe l�epastmeni of Inspection Services for rhe priae. <br /> The und�rsigned l�ereby applies ta thc City for issua�c�e of a Plumbing Permit, agrees to do a11 <br /> v�rork in strict accordat�ce with the ordin�nccs of the City and the regulatioas of the State of <br /> Minncsota, and certifies that a11 statements made oa this application aze complete, true and <br /> correct. <br /> Applicant's Sigz�arur��'.�. i Cl� `����_K U�, — T�ate: �- ' �J <br />