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Permits - Permit# 7-27-03 - 3826 Budd Lane - 1/1/2003CITY OF SPRING PARK 4349 WARREN AVENUE SPRING PARK, MINNESOTA 55384 952-471-9051 APPLICATION FOR PLUMBING PERMIT GENERAL INFORMATION 1. You may apply for plumbing permits by mail or in person at the City offices. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE, 3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property owners residing in the dwelling. 4. When any new construction or remodeling is involved, a separate building permit must be obtained. 5. All work must be done in accordance with the State Code requirements. 6. All work must be inspected and air tested before it is covered. Call 952_-2494600. A 24-hour notice required. INSTRUCTIONS Complete all items on this application. Compute the permit fee. Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 952-2494600. Please check one: New Addition Repair Replace p� X Residential Commercial JOB SITE: . - Owner's Name Mailing Address _ Contractor's Name Mailing Address _ Number 170 Number FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER TYPE FL FL TYPE FL FL Kitchen Sink Water Heater Disposal Water Softener � Dishwasher Wet Bar Sillcocks z Sprinkler Sys. il( A Plumbing Permit Application 2002 State Statute Yes, This Section Applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: 1) Does not require modification to electrical or gas service. 2) Has a total cost of $500.00 or less excluding the cost of the fixture or appliance; and 3) Is improved, installed or replaced by the homeowner or licensed contractor. Skip next section; If above does not apply, follow guidelines below: Cost of Permit S 15.00 State Surcharge $ .50 Mail In Fee $ 1.50 1. 1.25% Of Contract Price* or Minimum Fee ($35.00) '�/P, Oa Shoo x .0125 Contract Price 2. State Surcharge. ** Add the State Building Code Division I Surcharge to each permit " /,n, DaS',dV x .0005 Contract Price or $.50, whichever is greater 3. Postage and Handling 4. TOTAL PERMIT FEE (Only mail -in applications) (Add lines 1-3 above) s_22 5,31 S 9, ©_'2, S $1.50 S a-3s.93 * CONTRACT PRICE OR JOB COST means the actual or estimated dollar amount charged for the permitted work including materials, labor, profit, and other fixed costs. It is the amount to be charged to the customer for the work done. If any material, equipment, labor, or installation are -furnished by the owner, tenant or any other party the reasonable market value of such items must be added to the estimated cost or contract price for the permit fee purposes. In the event that there is a dispute on the amount of the job cost, the City may request the submission of a signed copy of the actual contract. ** The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50, whichever is greater. For valuations over $1,000,000 call the Department of Inspectional Services for the price. The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in strict accordance with the ordinances he City and the regulations of the State of Minnesota, and certifies that all statements made on this a is tion are Aplete, true and correct. Applicant's Signature Date7/9�r 3