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. <br /> ' � ���tl��il'�' ' �F S��7'I.�.,...�..�.QN <br /> 1, �.25�'� of�„o..r�,,�t,�r�,�* ar ��, w F� ( O) <br /> t tP°t(� -- - -- x .0125 $ �,� <br /> (coz�traCt price) <br /> ?. St�te Sur�har�e, *�" Ad� the State Build�ng Cad� Uivision ,. <br /> Surcharge t� each �ermit. �10�2 0 � x ,pt�5 $ �'�5 <br /> (cantracc p�ics) � - - --�` <br /> �r $.50, whichever is greater <br /> 3. I'c�stage_anci_I a dli (C?nly mail-in applications) $ _ _ 1,�0_ ____ <br /> 4. TdTAI. Pk,KMIT FEE (Add li.�es 1-3 above) $ �'�,3�_^_ <br /> " G!'JNTRA�'T PEtl�E or JOB COS'I'meuns the a�tual or esttm�.tcd dpltar�rnount chargcd fOr the permittcd <br /> �vork incltxiing matanals, labor, proUt, a.nd otlte� ��ccd costs. It is the amount iu bc charged to the <br /> cussomer f�►r thC work dene. If any material, tc�ulpmcnt, lAbor, ar iastallation arc futnlshed by tlie owncr. <br /> tCaarit ar any other party the reaspnabl� market value c�f such items niust bt addtd ro the estitnaied cost <br /> or eontract,price for ptrmit fee purposes. In tht cvcnt that thcrc is a disputc on the a�nount ak'the job cast, <br /> tha City mey c�equest the subrt�issian o[a s[gned copy of the actuaf cc�ntr�ct. <br /> *"' Thc STATE SURC:HARG� is .()UQS of the contraet pric� under $1,000,000 or $.SO - whichavar is <br /> $rcafeC. FOr v�luation� aver $1,(}p0,Q00 tall the Department af lnspectiona�l S�rvices fur thc price. <br /> The undersigned hercby �pplies to th� City for issuance of a Plumbing Permit, a�r�es to d� aIl <br /> w�rk in strict accardance with the arciinance5 of the City and th� r�gulations of the State of <br /> Minne�ota, �nd cenifies �tjat aI! statem�nts mad� on this application �re eomplet�, krue and <br /> GOfTCCt. <br /> Applicant'sSigs�ature. _ _ _� l�ate� _(,Q '2� t�_7i <br />