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:�NSTALLED� � ;���-=x s' N�'�,� f��r�;�� �: <br /> �,, * � ��� m �� ,`}��;U�IIBING F.IXTURES.�E1�1G: �.�, r.�� y5.. �a — <br /> �;��r. � ���.> �.�, <br /> FIXTURE BSMT 1sT ZND OTHER FIXTURE BSMT 1sT 2ND pTHE+�tf � <br /> NpE Floor Floor TYPE Floor Floor <br /> Water Closet 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 <br /> Sillcocks Miscellaneous <br /> , �r �: �� .�c �- .�� �; .,' <br /> ,_- �w � <br /> �* s�,sl� �"�r-�,<��s `�'i�-!�3'� i x'� � �i� � � <br /> Y �`,�,� �`�-� a...��4�m, rA ��.,,s y,_�;;��"�,.� N � 'q, �t„ �� x ?�y, '`� ,r :.rr <br /> �"e++'�t»�� .,�` <br /> 1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> ��QQQ �= x .0125 $ <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> x .0005 $ <br /> (contract price) <br /> 3. POSTAGE 8� 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 /> k� sE " �,'./7���;�T.k6.��..����_' l'1V .��� �t 5�' ���` ie5�s 4:: F�$� -� <br /> ,�� �{�����'ay ,�x�� ,�,�: �L� µ��I�G,�' ;�' r �E,��. ��°°� <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 /> ApplicanYs Signature: Date: 7— �/./'��� <br /> Building Official/ Inspector: Date: <br /> Page 2 <br />