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F�RMI'�'F�E+Ct�I,+�;tT:[..t�'I'T�?�� -J(�B�t�!�R..$�U4.f� <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Miniroum Fee of$50.00) <br /> 16,565.00 x.0125$ 207.06 <br /> (contract price) (minunum$50.00) <br /> 2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of 5.50) <br /> 16,565.00 x.0005 � 8•28 <br /> (contract price) (minimum$ .50) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERNIIT FEE(Add Lines 1-3 Above) $ 217.34 <br /> ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials,labor,pro�t,and other fixed costs. It is the amount to be charged <br /> to the customer for the work done. If any material, equipment, labor or installations are furnished by <br /> the owner,tenant or any other party,the reasonable market value of such items must be added to the <br /> estimated wst or contract price for permit fee purposes. In the event that there is a dispute on the <br /> amount of the job cost, the City may request the submission of a signed copy of the actual contract. <br /> ■ ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or$.50—whichever is <br /> greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. <br /> PLL��!�P'�Tv�TT APPLIC�T���.A.aC'rA;EF:l�lE1�3T` <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees 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 a11 statements made on this application aze complete, true and <br /> conect. <br /> Applicant's Signature: L( Date: � (� <br /> ��FO�i#1 <br /> 3 <br />