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1 <br /> FIX'TUR� BSMT 1sr 2"D QTHER . FIX�'URE BSMT 1sr 2N4 OTH�R <br /> Typ� Floar Floor 'TYPE Floor Flpar <br /> Water Cioset l � Floor orains 1 `.- � �-� <br /> Lavatory ' ` Sewer�jector <br /> Bathtub � � Laundry Tray ' � �G �� <br /> Showe� Washer � <br /> Kitchen Sink Water Heater � <br /> Disposal � � Water Saftene� <br /> Dishwasher � Wet Bar <br /> Siltc�cks � Miscellaneous � <br /> 1. CON7RACT PRiCE " is 1.25% of contract price with a(Minimum Fea of$50.Q0) <br /> p� 8, � 5� x .0125 $ J��' i <br /> � �(contract price} (minimurn $50.00) <br /> 2. STATE SURCHARGE <br /> ��, �5� X .oaas $ 1 �(• �3 <br /> . (contract price) <br /> 3. PQSTAGE & HANDLING (Only on Mail-In Applic�tions) $ 2•�0 <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) � �� �� �� <br /> ' CQNTRAC7 PRICE or JOB COST means the actual flr estimated dollar amount chatged for the <br /> permitted work including materials, labor, profit, and other fixed costs. It is the amount to be charged ta <br /> the customer for the work dane. If any material, equipment, labor or installatipns are fumished by the <br /> owner, tenant or any other patty, 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 ta the City for issuance of a Plumbing Permit, agrees to do all work in <br /> strict accord�nce with the ordinances of the City and the regulations of the State of Minnesota, and <br /> certi�ies that�11 statements made on this application are complete, true�nd correct. <br /> Applicant's Signature: '�-� p�te; � f t(�t� <br /> Building OfficiaU Inspector: pa�B�- • <br /> Page 2 <br />