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6/30/10 03 : 49PM CDT Spring Plumbing LLC —> Barb 9522494616 Pg � <br /> 5 <br /> . <br /> . � � � �� PERIVIIT FE�•CALC[JLATIQN(5). � � � ' . . . <br /> � � � �. .�ASED�OFF-200� STAT',E'STATUE� � • • �� . . <br /> � Ycs,this seaion applies <br /> � <br /> T6e replscement of a Residential fixture or aoolianoe that meseS ali three of fi�e Followiqg roquiromecits: <br /> 1. �Amt requite modifiaasioa w sleetniml or ges seprviae. <br /> Z, Has a 1o38L4�L of�500.00 or leas;�JuQjpQ t,he cost of t�a�ixttue oc appiiance:and <br /> 3, ia improve,d�iAstalled or replaceB by the hou►oewner e�1ioa�ed contractor. <br /> Slcip naoct sectioa,if tbia applies; Cost of Pamit S 15•00 <br /> St�te SurohArga S s.00 <br /> Mail-in Foe(If Appli�ablv) S�QQ <br /> TotAl Permit Pbe S <br /> . `..PERMIr FEE•CALCU•LATTOltiT S. —.3OBS Oi/ER SS00.00" ' � <br /> ��pV!QO@$QOt El��y►;fO110W$1l1dQ1111�bAlOW: <br /> i. *its l.zs%of contract price wirh a(M;aimum Fe!or sSo.00) <br /> 470.00 ` X'o1�5 s 50.00 <br /> C���) C��n sso.00� <br /> 2. STATE SUBCR/1AGE **Add the Sffite Bldg Code Div.6urchnrgc(Miqimum P1ee of�.00) <br /> 47Q.00 x.0005 $O.Z'4 <br /> ; (uu�xecl�aice) (minimum S 5.00) <br /> 3. POSTAGE&HANDLllVG(Oniy on Meil-In Applicatioas) � 2_00 <br /> 4. TOTAL PEBMIT FEE(Add Lira l-3 Above) S`52.24' <br /> � • CON'I�iACT PR1CS or JOB COST means th�actual or�tuoeted dollar amouz►t ohscgod for t6e <br /> pantittsd work inciuding mate�rials�labor,�ofit,ead othec fixed costs. It is the amoune m ba charged <br /> fio ths eu�tomer foc the worlc dv�e. If say n�ste�ial,equipn►ent,labar or i�bllstioas sre furniak�ed by <br /> the owner�benaat or any otl�er party,the�essonabJe merket value of such items must be addod to ths <br /> esri:nated ao3t o�eont�act priea foor penmuit fee putpases. Lr t6e eve�t that there�s a dispute on the <br /> amounc of tbe job cos�,the Ciry noay raque�t tt►e subm�issi�oia o£a sianed oopy o�the actusl eantrack <br /> • "'ihe STATE SURCFIARGTs ie.0003�fine��e ConvaCt Prir�e or s miaiawm of$5.W. <br /> � � �MECHAIVICAL PERNIIT APPLICAT�ON A�GREEMENT � <br /> T'he underaignad hereby applies to the City fo�issueace of s Meohanioal Permit, a�grees to do all <br /> work in sl�iot aaaordanoe wit]� the ord�nancas of the City and the regulati� of 4hc Statc of <br /> Minaesota, and certrf'ias that all statement� xnada orl this application erc aomplete, true and <br /> corrcct. , <br /> r ' 2 <br /> Applicant s Signatura: �� Date: J� �Q <br /> �R�st I�rr�n a <br /> � <br />