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� � � i i! <br /> FIXTURE BSMT �ST 2ND 07HER �IXTURE BSMT �ST 2ND OTHER <br /> TYPE Floor Floor TYPE Floof Floor <br /> Water Claset Fioor Drains <br /> Lavatory Sewer Ejector <br /> Ba#htub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Silicocks Miscellaneous <br /> �. , <br /> � � <br /> � <br /> 1. CONTRACT PRICE *is 125°lo af contract price with a(Minimum Fee of$50.00) <br /> x.0125 $ �� <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> x .0005 $ g 2..� <br /> (contract price) <br /> 3. POSTAGE& HANDLiNG (Only on Mail-In Applicatior�s) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ,:__�� ��� <br /> * CONTRACT PRiCE or JOB COST means the actual or estimated dollar amaunt charged for the <br /> permitted work including materials, labar, protit, and other fixed costs. It is the amount to be cMarged to <br /> the customer for the wark done. tf any material, equipment, labor or installations are fumished by the <br /> owner, tenant or any othe� party, the reasonable market value of such items must be add�! to the <br /> estimated cost or contrac# price for permit fee purposes. In the event that there is a dispute on th� <br /> amount of the job cost, the City may r�uest the submission af a signed copy af the actu�l contract. <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in <br /> strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and <br /> certi�ies that all statements made on this application are compie#e, true a�d correct. <br /> ApplicanYs Signature: Date: <br /> Building 4fficieU Inspector: Date: <br /> Page a <br />