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i 1- <br /> �' � ` '� �� �T�?�LU�7I�ING FIXTURES 8E11VG°`INSTALL"EDk�' �`"��,} �����`�x :. ., _. .�� ���:, � � <br /> .t <br /> �8{���ry`�,�97 �� �� Ie�b Y Fi 4�' <br /> FIXTURE BSMT 1sT 2ND OTHER FITMPE E BSMT Floor Floor �THER <br /> TypE Floor Floor <br /> Water Closet � 'z Floor Drains '� Z <br /> Lavatory \ �j Sewer Ejector <br /> Bathtub � Laundry Tray � <br /> Shower , � Washer � <br /> Kitchen Sink � Water Heater � <br /> Disposal � Water Softener <br /> Dishwasher � Wet Bar � <br /> Sillcocks Z � Miscellaneous <br /> .�a +,t'�r � :'} ,'�, "A '+Z'a�'+ v�J + '. <br /> t +.��s��' � ��m �s��i+,��.�`. �`��,`'f� M!�..�v��,y�i � ���� � t�-*�X^��'°Y"�t>a�3.�',-k� 3; �,^'?,'�"3`k�, ._�`,-�.�.'�' '�; <br /> -�+ -} � �� '-''`�, :�vs� <br /> 1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> �'/�,(,�,p x .0125 $ <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> x .0005 $ <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 /> * 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, tenant or any other party, the reasonable market value of such items must be added to the <br /> estimated cost 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 /> yyy��,,��� �,' -� , ` ��s��.` � �:�r <br /> r IT �� ' k.z �Z � �•��.�' i,j;)ff�.s �w'`W°�''�.: �'�- r,y,'�� �*� <br /> .��'��������;���, �w�.�>. 4��-�71�(B�NG P-�tA��'�./��?YL`��A�' R � a .� <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 /> certifies that all statements made on this application are complete, true and correct. <br /> Applicant's Signature: Date: �Z—�""�7 <br /> Building Official/ Inspector: Date: <br /> Page 2 � <br />