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Mar. 19. 2009 11 :47AM Norblom Plumbing � No, 9615 P. 1 <br /> PERNIIT�'F.E CALCULATION S —JOBS OVE�2$500.00 • <br /> If above does not apply;follow guidel3nes below:• • . ' <br /> 1. CONTttACT PRYC� ��s 1.25%of�ontracc prioa wrth a(Miuicr;um Fee of$35.00) . <br /> • x.a l25$ . <br /> (contact price) (min�ma S�S,oU) • <br /> 2. STATL SYIXtC�1�tGr� **Add t�e S�te Bld�Code Div.Suroharge(1►�Iiaimu�a Fea of$SO) <br /> � x.0005 $ <br /> (conusct price) (minimum 5 SO) <br /> 3:P+OSTAGE&�L4NDI-XNG(Only on Mail-Tn Applications) $ 1.50. , <br /> 4. TOTAL PERiVQ'��EE(Add Lines X-3 Above) S i7' �� <br /> • # COIVTRACT PRICE ar JOB COST mes�tbe actual or eslimated dollar�n4u�t cllatged for t6e <br /> . permitbed wark includ"ung metesisls,labor,profi�and ot3ier Sxed costs. It i�tb�e amouat to be cbar�ed <br /> . to tha cuswmer for 4he work doae. If say material, equipm�t,]abar or installations are fumi,shed by <br /> the owner,teneut or airy other party,the reasaDsble market value of snch iteAos must be added to the <br /> astuae�ed cosZ or ccntract price for permit fee purposes. 7n �e eveAt that tbere is a dispufie oa'tbe <br /> amount of i'he job cost, the City may reqn�at the snbmjssio� of a sisned copy'o�"the actuax'co�r,f�rac�,• <br /> ■ *'�Tha STATE SURCF�ARCx�is:0005 of tlte con4�t�.c'C price Under$1,000,000 or�.SQ,-whiohevar is <br /> greatar. For valu�sioas ovor$I,D00,000 aall the Buildmg Departrnent at(952)249-4600 for the griEe. • <br /> � PX,C7Ml31NC�PERMX�.A,PPT,��CAT�10N AGrREII�'T, ' .: . ' <br /> 'l'1�e unders�giaed.hereby applies to the City.for issuauce of a Plumbing Parmit, a�eas to du all <br /> ' ' v�r'oik in'sD�ict ac�3rdance vv'itb�'tlie ord'unaaces of the CiCy a�n6 tha regulations of the Siate of ' - - <br /> • Nlionesota, and certlfies that all statemezlts made on th�is a�plicariam are crnmplet�, true aud , <br /> �oirect. � . -- <br /> Applicaat's Si , , Date /r�` � ` ; � _ .. <br /> gn <br /> , . <br /> Reset Fomt <br /> ;� <br /> J • ' ~ <br /> ._ . • • .. . . ' I� . <br /> 1 • <br /> � � <br />