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�� �'��� ` �;��Y��;:�:.`�?�U�181NG F.iXTURES,=$��N!G:II�STALL�D�x ,�*,�� h4�f���� . ,Y��,����,� .. . <br /> :�.�� �r.�;4.�.,,k: ,�. <br /> FIXTURE BSMT 1ST 2ND OTHER FI�PE E BSMT Floor Floor OTHER <br /> TypE Floor Fioor <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 Miscella�i�us � <br /> �y. `� � `� �'''3 � -�:� ���� � '�x 5�.;��xs� a ur �+�i �'�"„"' �� t��,�:. <br /> S �1': ���*°�.r4 A ' `'��'° -9 3 rh .�� �.�.Y,-.#�s »"�,r °�4 �s�,•!�n�, t <br /> Y �;.R �A t�:.� "� <br /> 1. CONTRACT PRICE " is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> `�,5.7;�''< d(� 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 /> ._ .,y - �y -A }� � <br /> �y� /� �y� _��r �`�R�� ` �' ��` _�' ���,� ���� <br /> ���. � n �__S��A tX ��1�+�����17J���!n'.9�1^'le���� _ .x..Y'L'U'�,"''�t`@'� �' �ss;P _ ..�s�: <br /> .� ' ' � . . , .... .. � <br /> + -r •,.. ^C F�(.,,-. M S.. . . , _. .. �... <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 ma on this ap lic tion are complete, true and correct. <br /> %"�/ Date: ���� � / <br /> Applicant's Signature: -�--�— <br /> Building Official/ Inspector: Date: <br /> Page 2 <br />