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09/29/2014 13:1a FA% 9529aa5049 CULLIGAN MNTRA 1�004 <br /> . � � . <br /> 1 <br /> ;,���;�.,�����' - „s,w�;.pE�'i,'���A��CI:TI:3i�T�'�1'�T(S�''�T�a'-JOB��Q,���$���00'�`p0`.;���s':'.��r,:�;�''�;��'.�'- � <br /> If above does not apply;follow guidelines bElow: <br /> ]. CON'I'RA .T PRICE *is I.25%vf contract price with a(Miniunum Fee of$50.00) <br /> x.0125$ <br /> t�n�pri�) (minimum 55D,00) <br /> 2. STA1'L�SURCFIAl2GE *Y Add 8te Sta�Bldg Code Div.Surcharge(Minimum Fee of S5.00) <br /> x.0005 � <br /> (conlract price) (minimum S 5.00) <br /> 3. POSTAG�&HANpLING(Only on Mail-In App)ications) $ 2_00 <br /> 4. TqTAL PERMYT FEE(Add Lines 1-3 Above) g �a, �� <br /> ' ` CONTRAGT PRiCE or JOB CpST means the actual or estima�ed dollar amount charged for the <br /> permittcd work including materials,la6or,profit,and other fixed costs. it is the amounc to be charged <br /> to the customcr for the'Work done. If sny niaterial, equipment, labor or installations are fumished by <br /> the owner,�enant or any ol'her party,�he roasonable mArket value of such items must be edded tp thc <br /> estimaCed cost or eontract priee for permit fee p�uposes, In the event that there is a disputt on the <br /> amount of the job cost,the City may request[he submission of a signcd copy of the actual contact <br /> ■ •r The STATE SURCw1ARGE is_Ob05 of the contract pricc under$1,000,000 or$5.00—whicl�ever is <br /> grcatcr. fior velu�tions over$1,000,000 calI ihe Building Deparhnent at(952)249-4600 for the price. <br /> �.M � � J � ;Yr,�b� "�`�{ '; "" ; � <br /> uki, '�:. <br /> The undersigned hereby applies to the City for issuance of a Plvmbing Permit, agrees to do a11 <br /> work in striet aecordanee with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are eomplete, true and <br /> correct. <br /> Applicant's Signature; �.J Date• - � <br /> _► <br /> �'.�e1V�9� . ��KC:m <br /> 3 � <br /> . i <br /> i <br /> i <br /> i <br />