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Stewert Plumbing, Inc. 7634281733 p.6 <br /> ., ` PLUMB(NG FIXTURES B lf�G INSTALLED <br /> FIXTURE SSMT 1ST 2ND OTHER FIXTURE BSMT �sT 2ND pTHER <br /> TYPE Floor Floor IYPE Floor Fbor <br /> Water Closet � � � Floor Drains � <br /> Lavatory � � 3 Sewer Ejector <br /> Bath#ttb � Laundry Tray <br /> Shower �' Washsr � <br /> Kitchen Sinfc � Water�Fieate� � <br /> Disposat � Water Softe�er <br /> Dishwasher Wet B�r { <br /> Silloocks 3 Miscell�neous <br /> . <br /> PERM(T FEE CALC LATI�N <br /> 1. C4N7RACT PRlCE � is 1.25% of contract p�ic�with a (Minimum Fee of$50.O�j <br /> � �, �l�L��t�(U x .0125 $ �.�.� 0 U <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> � �.�Z? GG►c�• L�� , x A�05 $ �.� �'� t. <br /> (contract price) <br /> 3. POSTAGE � HANDLING(Only on Mail-In Applicetions) $ 2.00 <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ � ���. �Ti <br /> " CONTRACT PRICE or JOB COST means the actual or estimated dofiar amo�nt charged for the <br /> permitted work including materials, labor, profit, and other fixed costs. It is tFte amount to be charged to <br /> the customer for the work done. If any material, equipmen , labor or installations are furnished by the <br /> owner, tenant or any other party, the reasonable market alue of such items mus# be acfded to the <br /> estimated cost or contract price for perrnit fee purposes. n the event that there is a dispute on the <br /> amount of the job cost, the City may request the submissi�n of a signed copy of the actual cantract. <br /> PLUMBING PERMIT APPLICATi N AGREEMEI�T <br /> The undersigned hereby applies to the City for issuance o�a Plumbing Permit, agrees to do a!I work in <br /> strict accordance with the ordinances of the City and the r�egulations of the State of Minnesota, and <br /> certifies that alf sfatements made on this applicaiion are com�lete,true and carrect <br /> i ,� <br /> ApplicanYs Signature: �Ce. �,�?',�'��'7'� �I Date: !��I�-� 7 <br /> �I <br /> Building Official/Inspector: Date: <br /> , <br /> Page 2 <br />