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PLUMBING F1XT.URES.BEING INSTALLED , � �` <br /> FIXTURE BSMT 1sT 2ND OTHEP. FIXTURE BSMT 1sT 2ND OTHER <br /> TYPE Floor Floor TYPE Floor Floor <br /> Water Closet Fioor Drains <br /> Lavatory Sewer Ejector <br /> � <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Misceilaneous <br /> PERMIT FEE CALCULATION <br /> 1. Cfl�l�e�,��C� �r.lC� * is 1.25% of contract price with a (i�1�;,imum �e� o���a.flC) <br /> x .0125 $ �� . DD <br /> (contract price) (minimum $50.00) <br /> 2. S a.!?Tc S��r:�y,'�r'�G� <br /> x .0005 $ �. a D <br /> (contract price) <br /> 3. �flS�^.G� g NA��3L1�1G (Only on Mail-ln Applicaiions) $ 2.00 <br /> �. 30TAL ��R�ill� F�� (Add Lines 1-3 Above) � v�• � � <br /> � CON i P.ACT PRICE or JOB COST means ihe actii�l or e�timaterf rlollar amn�_�nt rharnPri fnr th� <br /> permitted work including materials, labor, profit, and otfier fixed costs. if is �he 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 oi 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 /> PLUMBING PERMIT APPLICATION AGREEMENT <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 regulat��s of.the State of Minnesota, and <br /> certifies that all statements made o �s appiicatio are compiete, true and correct. <br /> ���� <br /> Applicant's Signature: Date: �I I �� <br /> ,; . <br /> Building OificiaU Inspector: Date: <br /> Page 2 <br />