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:3G'�3'"i��4 �a::laR FfC�N.I � �F �PQNG <br /> +96224ed616 T-642 p J03/003 F-6G? <br /> YER1�'r l�'�;E CALCL'I..A'�ION�S� <br /> �0 2 State i e � y'es, This Sectian Applies <br /> � <br /> The replacement of a R�sidenti 1 fixtur� or a�,pli� nce that rz�eets ail three of the foil�wing <br /> requirements� <br /> 1) _ ��es not require modification ro electrical or gas service. <br /> 2) Has a total co� of Sa00.00 or less; g.�lud� t!-.e cost of the fixnire or applisince; <br /> and <br /> 3) Ts improved, installed or rcplaced by the homeo��vr�: or liceru:ed contracCor. <br /> S}up nex[ section; Cost of Pec7nit � . _ _15.00 <br /> Stace Sorcharge $ �p r� <br /> Mai] Tn 1 ee g _ 1 5p <br /> lf above does n�t �pply, follow guidelines below: <br /> 1 C�nu��t Price�` is .0125 °7 of job with a Minimum Fee of �.00 <br /> �� � � <br /> `�� x .0125 $ ,���,a7S <br /> (concrac; pnce) (rninunum S35.UU) <br /> ... State Surchar��. "* Add the S�ate Building Code Division a (ldinimtun Fee of$ .501 <br /> �-c> <br /> � � l — x .0005 � �J ��, �� <br /> ( o�tract pr,ce) r -�---"''`"'�_---_ <br /> minimum $ .S�) <br /> 3. PostaEe and Han_c�l� (Only mail-in applicatior.$) $ „� : 50 <br /> 4. TU1'AT. PER'�1IT FE� (Add lines 1•3 above) S j�f, <br /> ____�!__ <br /> ` CUN7RACT PRICE or JOB CUS'1'm�ans t�t actual or escunated da:la� arriount charged for t2►c permitted <br /> xork includm�rr,acerials, labor,profir, zr.d act;er ixeu coscs. it is�he amount to bC charged eo the cus:ome: <br /> for the u�ork done. If any ma;rri�l, equipmzr.t, lab4r, or inscalla�ion ate fur-�ushed by thc owntr, tenaat or <br /> ��y ocher parcy �he rensonabie market va�ue of such items must be adGed to t:�e es�imaeed cost or concract <br /> pr�ce tor perniu fee puiposes. In c�;ecen�tha� �:ere is a dispu�e c>n thc arnount of he job cost, u�Ciry r,iay <br /> rcq;ust;he subaussion of a �i�ied cop�oi c}e ar.n�al contraet. <br /> `` The S"fAT6 SL'RCH�IRGE is .0005 0:'�:e contract p;�ce t:t�der$1,000,000 0� �.50 • whichever is greacer. <br /> F'or valuarior,s over$1,OOO,C00 ca11 tht Depa:cm�n;of lnspect:cn 3er�ices fvr chc price. <br /> 7'he unciersigned hereby applics to the City for issuance of a Plumbing Permit, agrees to do a11 <br /> work in strict accordance �vich the ordi nee of th� City and the reguiations of the State of <br /> Minnesoca, and certifies rhat all tat. � e on this app;ication are complete, uue and <br /> correct. <br /> Applicant's Signaturc: 7/ � Da[e: <br /> � �_.� - <br />