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,�.: , . . , � ..,i�'� �IG�,�'�i'UR�S'SE1N�r�l,�I��,A1,���� � °�����'`, <br /> �� •.� -� � r �_ <br /> ,�� ,� �.�� :�. .,4.%� � ����;� <br /> �1 <br /> FIXTURE BSMT 1ST ZND OTHER FIXTURE BSMT 1sT 2ND OTHER .i <br /> TYPE Floor Floor TYPE Floor Floor <br /> Water Closet � Floor Drains �- � <br /> Lavatory L/ �f Sewer Ejector <br /> Bathtub Laundry Tray � � <br /> Shower Washer <br /> Kitchen Sink � �. Water Heater � '2 <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> . , . u,,-F �� . .��, .,�. <br /> a�,. <br /> 1. CONTRACT PRICE * is 1.25% of contract pri�with a (Minimum Fee of$50.00) <br /> J� ��v x .0125 $ <br /> (co ract 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 /> „ , <br /> ,.. ,. � w � ,���;� � �� � � <br /> ���,�� " :w� � ��`����'��A�� ax sx �, ���'x �;'s.���"�s� ����'a���r <br /> � ��� �. <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: <br /> Building Official/ Inspector: � Date: <br /> Page 2 <br />