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11l0412015 15:27 Steinkraus Plumbing �A�9�1� P.004l004 <br /> �•�, <br /> �. .. ��: <br /> ' , - <br /> . .., .. .. .. . . <br /> ' :'�.:;���E�T.FEECA�L,CI.TI;ATION 5..-:JOBS.OVER:$500;00.�:;. � .� .� :.` <br /> if above does not apptq;follow guidelines below: <br /> t. CQN'i'RACT PRICE *is 1,25%of contract price with a(Mininnurr►Fec of$50.00) <br /> ��'l�i(7°�^'' x.Ot25 S ��'a''� <br /> (confxact pricx) (mioimam$50.46) <br /> Z. 5"I'ATE SURCHARGE i, <br /> �`7G'C,� x.0005 $ �j�� <br /> (contrast price} • <br /> 3. pOSTAGE&�AND�.�1'G(Only on Mail-xn App[ications) $ 2.00 <br /> 4. TOTAL�'E�tM[T k'EE(Add L"snes 1-3 Above) $ _��+�� ____ <br /> ■ '� CON�'RAC'��RIGE or JOB COST means the actual or estimated dollar amount charged fbr Che <br /> permitted wark inciuding materiats, [abor,p�o�t,and otEzer fixed costs. It is the amount to be charg�d <br /> to the custorner for t6e work done. If any material,equipment,labor or insY,allations sro furnished by <br /> the owner,tenant or ar�y other pa,rly,the reasonable market value oP such it�ms must be added to th� <br /> estim�ted cost or cozettirract price for permit�ee purposes. In tha overn that there is a dispute on the <br /> amount of tkte job cost,tkAe City e�nay request the submission of a signed copy of tlze actual contraet. <br /> ..:...........,�. . _.,... <br /> .�.,.,...:.:..,,,,:;;..:,..�:.;:;��;.��. :. ' �';: <br /> :.t�..•...�v• 4.:: ..: i. •• ' :.' .. <br /> ..`. � ... ..:•.. • <br /> . r. . <br /> ... ...v.. r� �� . i : <br /> '����. ....... <br /> w� �,+ r '� <br /> �. .1-:ry .... ...... .. ��....a o ... • • :�; • ' •`:".':. <br /> .;..�,:...�:..,,:.;....�,,.:...:::...:.... . . .. . �:�'x,�:;,�.`+ �. .�LXCA.TIO�'�AC%I�E�1V.�E1�"�i;:�;:;;;..?.,;;:;,s:::+:;;,Y:�:'`; ;;-� <br /> . .... ..�....... .... .. . ....�. �.. .. ,,�..J�.��'y�.? . _.. ...... ..�............ . . ......... _�:.. <br /> . The uz�dezsxgtxed k�exeby a��ii�s to the City �or issuance of a Plumbing Permit, agrees to do all <br /> work in strict accordance with the ordinazxces of�e Cxty attd tktE cegulations of th� State of <br /> Mi�ttxesota, apd certi�es that all statements made on this apptication are complete, true and <br /> correct. <br /> .A�plxcant°s Signature: � Date: ���'�~�� <br /> 3 <br />