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1 - *. <br /> FIXTURE BSMT 1sr 2ND OTHER FIXTURE BSMT 1sr 2ND OTHER <br /> TYPE Floor Floor TYPE Floor Floor <br /> Water Cioset � � Fioor Drains � <br /> Lavatory � Sewer Ejector <br /> Bathtub 3 Laundry Tray <br /> Shower � Washer � � <br /> Kitchen Sink Water Heater <br /> Disposal 1 Water Softener <br /> Dishwasher 1 Wet Bar I <br /> Sillcocks Miscellaneous � <br /> 1. CONTRACT PRICE "`is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> �� � . � �1 �, C� 17 x .0125 $ ��y. "I � <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> 7� � � � �� �.L�� x .0005 $ � ' • � � <br /> (contract price) <br /> 3. POSTAGE 8 HANDLING (Only on Mail-In Applications) $ �t.Q�" <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ _ � I � ��� <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 fumished 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 /> 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 atl statements made on this application are complete, true and correct. <br /> A licant's Si nature: 4"�C"��� Date: � � �� ' l � <br /> PP 9 <br /> Building Official/Inspector: Date: <br /> Page 2 <br />