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� . <br /> FIXTURE �SMT 1sr 2ND OTHER FIXTURE BSMT 1sr 2ND OTHER <br /> TYPE Floor Floor TYPE Floor Floor <br /> Water Closet � � �j Floor Drains � <br /> Lavatory � Sewer Ejector <br /> Bathtub Laundry Tray ( <br /> Shower � Washer � <br /> Kitchen Sink � ' Water Heater � <br /> Disposal � Water Softener � <br /> Dishwasher � � Wet Bar I <br /> Sillcocks ; 3 Miscellaneous � <br /> 1. C{7NTRACT PRICE "`is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> -1 � ��-� x .0125 $ � � � • � � <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> ` `P � � �- � � x .0005 $ � J` a� <br /> (contract price) <br /> 3. POSTAGE & HANDLING (Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE Add Lines 1-3 Above $ � � � � � � <br /> ( ) <br /> " CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor, profit, and other fixed costs. It is the amount to be charged to <br /> the customer for the work done. If any material, equipment, labor or installations are furnished by the <br /> owner, t 'nant or any other party, the reasonable market value of such items must be added to the <br /> estimat cost or contract price for permit fee purposes. In the event that there is a dispute on the <br /> amount f the job cost, the City may request the submission of a signed copy of the actual contract. <br /> i <br /> The un�ersigned 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 /> certifie�that all statements made on this application are complete, true and correct. <br /> ApplicanYs Signature: ��� '�'`-'r_�1 Date: CI ��� '� � <br /> Building Official/ Inspector: Date: <br /> Page 2 <br />