Laserfiche WebLink
Dec 05 16 12:45p Legend Services Inc 763-479-6003 p.3 <br /> PLUMBING FIKTURES BElNG INSTALLED <br /> � <br /> FIXTURE BS14AT �sr ZND OTNER FIXTURE BSMT 1ST 211D OTFfER <br /> TYPE Floor Floor TYPE Floor Floor <br /> Water Cioset � 1 Floor Drains <br /> Lavatory � ,;� Sewer Ejector <br /> Bathtub � Laundry Tray <br /> Shawer � Washe r <br /> Kifchen Sink Water Heater <br /> Disposal Water Svftener <br /> Dishwasher Wet Bar <br /> Silloocks Miscellaneous <br /> �!�' �-$K�t V.'+ft• �Q✓i't4'� - n-L t�ie;:sh — �f'=�F�cx (Z�le.<?i c �t�(,r ,;v �.2 � C�� <br /> PERMIT FEE CALCULATION <br /> 'I. CONTRACT PRlCE '" is 1.25% of contract price with a(Minimum Fee of$50.00� <br /> � 3�0�> X .0�25 $ ��% <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> �� 3�uC� �° <br /> x.0005 $ 0: <br /> (contract price) <br /> 3. POSTAG�8 HANDLING (Only on MaiE-In Applications) $��� <br /> 4. TOTAL PERMIT FEE �Add Lines 1-3 Above) $ �lx �� <br /> * CONTRACT PRICE or J�B COST means the actual or estimated doilar amount charged for the <br /> permitted work including materials, labor, profit, and other fxed costs_ It is the amo�nt to be charged to <br /> the customer for the work done. {f any material, equipment, labo� or Enstallat9ons are fumished by the <br /> owner, tenant or any other party, #he reasonable market value of such items rnust be added to the <br /> estimated cost or contrac! price far permit fee purposes. In the event that there is a dispute on the <br /> amount of fhe job cost, the City may request the submission of a signed copy of the acival contract. <br /> �LUMBING PERMIT APPLICATfON AGREEMENT <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in <br /> strict accordanc� with the ordinances of the City and the regulations of the State of Minnesota, and <br /> cert�es that a9!statements made on this application are complete, true and correct. <br /> Applicant's Signature: r/��' /�cz��� , � -1� <br /> ✓ <br /> Da#e: ��- <br /> Building �ficiall Inspector: Date: <br /> Paye z <br />