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, . n��-z�-ruuz oo,asam F!om-CIT" OF OP,ONO +OS22484616 T-8T8 P G06/GO6 F-9�5 <br /> ?t402 State Qr,�kp � Yes, This Sectton Applfes <br /> The repiaeement of e $�idcntiA] fixcure �r app 'encc tliat .tieC[s xll uucC of the fol�pt��ing <br /> requirements: <br /> �) �� require modification to eIectrical Qr gas service. <br /> 2} Hsis a total cost of$540.Qp or Iess; excl„_„_,u�¢ �e cost of the fixture or appliance: <br /> and <br /> 3} Is improved, installed or replaced by thc homeawner or licenced conuaetor. <br /> Skip ncxt scction; Cost of Pea�mit $ �,S,pp <br /> State Surcharge $ <br /> Mail In Fee $ 1.S4 � <br /> lf above does not apply, folIaw guidelines below: <br /> 1. Corrtr�ct Price" is .OI25 9b of job with a j�(j�Fee of (335 00} <br /> /d, ooc3 x .O I25 $ J� � <br /> (contract prict) (m{nimum S3S.00; <br /> 2. 4Lt� �nrrhnro�. w* Add the State Building Code Division a �nimurn Fec of$ .50) ��t' <br /> .�� <br /> x .00OS � � <br /> (cor.tract price) (minin�um S .50) <br /> 3. � and Hae �cng (pnly mail-in applications) $ � 1.50 'V <br /> _______.__ � <br /> 4• 7`O'Y'AI.PERMIT F'fiE {Add Iines 1•3 above� $ � �,�. � ��I <br /> * CONT'RAC7 PRICE or JOB C05T meta�tha aetual or estimated dollar amounc charsed for the permined <br /> work iaeiudi.ag a�uteriels,labor,profit,and other ftx�d costs. Tt is�he amou:u to be char�ed ro�hc customer <br /> far the work done. If any muer�al,equipmeat, iabor,a�r insial9arioa arc furrsis�ed by�he owner, cenant or <br /> ury othar parry tbe r�flsanable m�trket v�tlue of sucD items mnst be ldded to rhe estimxced cwt or contracc <br /> piiee for permit fee purposcs. In thc eveat d�at there is�dispuce on[he xmount of thr jab cost,che Ci:y may <br /> requ��c�9ub�sissioa of a signed copy o�the actual contract. <br /> "* Tbe 3TATE SURCHARGE is .00QS of the conrrut prict unde�51,000,000 or 5.50-vv�chevar is�reater. <br /> For vaivartons over$1,000,000 caJl the peparcment of Inspection Services for the price, <br /> 'T'he undersigneQ hereby a�pltes to the City for issuance of a Plumbing Pcrmit, agrees to do aIl <br /> work in strict accoidance with the ardinances of the Ciry and the regulations of the Scatc of <br /> Min.''►osc�ts, and certifies that atl statcrnents rnade on this �pp��cation are complett, uue and <br /> COTCCCt. <br /> Appticarn�S���Q�e. �i' K/ll� Lak: �� P'I���'r� <br />