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From:7634974263 03/�2/2018 08:06 #225 P.006/006
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<br /> FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1sr 2No OTHER
<br /> TYPE Floor Floor TYPE Floor Floor
<br /> Water Closet � Floor Drains
<br /> Lavatory a- Sewer Ejector
<br /> Bathtub Laundry Tray
<br /> Shower j Washer
<br /> Kitchen Sink Water Heater
<br /> Disposal Water Softener
<br /> Dishwasher Wet Bar
<br /> Sillcocks Miscellaneous
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<br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00}
<br /> ���� ! C�� . `�`� x .0125 $
<br /> (contract price} (minimum$5�.00) ,
<br /> 2. STATE SURCHARGE '
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<br /> x .0005 $
<br /> (contract price)
<br /> 3. POSTAGE 8 HANDLtNG (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 cha�ged 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. lf 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.
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<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 alf statements made on this application are complete, true and correct.
<br /> ApplicanYs Signature:��`--r �l`"-- Date: 3�a�� �
<br /> Building O�cial/Inspector: Date:
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<br /> Page 2 �-:;
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