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PER=FEE CALcCtCMA=0 <br /> 2032 SWIe 5 ❑ lrez9 TME SeLlIon Appmes <br /> The replacement of a IResidentihl Lh1we or aplsliance that meets all three of the following <br /> requirements: <br /> 1) Does mot requre modification to,electrical or gas service. <br /> 2) Has a toil cost of$500.00 or less; ogdin the cost of the dare or appliance: <br /> and <br /> 3) Is improved, installed or replaced by the homeowner or licenced.contractor., <br /> Slip next section, Cost of Permit $ 15.40 <br /> Mate Surcharge, $ .54 <br /> Mail In Fee $ 1:54 <br /> If above does not apply, follywr guidelines below <br /> 1 � cctt �g is .0 12,5 % of job with a 1 <br /> k .4125 <br /> ( ntract prift): Wnim=$� st t) <br /> Add the ate codei�isid� i i .50) <br /> x . 5 <br /> {eoatrad pn ) . (minbnum <br /> 3. t{A tE and-B1MOmi (Only ffia&]-fiappdons $ <br /> .- <br /> 4. TOT,& .PM9,T 34. (Add lines-1-3 above) $ <br /> CONTRACT PRICE or IOB COST means the actual or:estimated dollar amount charged for the permitted <br /> Vork including materials,labor,profit ad oft#.r fixed costs. It is the amount to be charged to the ti mer <br /> for the work clone. If any snatorial, ip ,labor,-or installatiora'arefimished y die owner,rant or <br /> any other_party the reasonable market'value of such items must be added to;tbe estimated cost or contract . <br /> price for permit fee purpascs. In the event that dwe'is a dispute o4 ft amount of the job cont,the City may <br /> request the submission of a signed copy of the awl contract. <br /> The STATE SURCHARGEis.WO5 of the contract price under$1;OOO,t�or $�50.whichever is greaat�r:, <br /> For valuations over$1000,000 call the DepaMnent of inspection"Services for the price. <br /> The undersigned hereby applies to the.City for ismmce of a Plumbing Permit, hg s to do all <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statements ode on this application are complete, tme and <br /> correct. <br /> Applicant's Signature: Date- <br />