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Stewart Plumbing, Inc. 7634281733 p.2 <br /> • PLUMBING FIXTURES BEING INSTALLED <br /> FIX�i"t.JRE BSMT 1sT 2ND OTHER FIXTURE BSMl" �sr 2No p��E� <br /> 7YPE Floor F'foor TYPE Flaor Floor : <br /> Water Closet a Floor Drains <br /> Lavatory � Sewe�Ejector <br /> Bathtub Laundry Tray <br /> Shower � Washer <br /> Kitchen Sink � Water Heater <br /> Disposal , ` Water Softener <br /> �ishwasher � Wet 6ar � I <br /> Sillcocks Miscellaneous <br /> PERMIT FEE CALCULATkON <br /> 1. CONTRACT PRICE ` is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> T <br /> �� �rf��� � x .0125 $ .��'�'. D� <br /> � rninimum $Sa.00 <br /> (contract price) t } <br /> 2. STATE SURCHARGE <br /> � � C,a <br /> ���; G(1 C.CC x A005 $ �', <br /> (contract price) <br /> 3. POS7AGE� HANDLING {Only on Mail-In Applica#ians) $ 2•o� <br /> �, <br /> 4. TOSAL PERMIT FEE (Add Lines 1-3 Above) $_,__—__��'-�"�C U � � � <br /> " CONTRACT PRICE �r ,lOB COST means the actual or estimated dollar amou�t charged for the <br /> permitted wark including materials, labor, proft, and other fixed costs. 1t is the amount to be charged to <br /> the customer for the work done. If any material, equ9pment, labor or installations are furnished by the <br /> awner, tenant or any other party, the reasonable market value of such items must be added to the <br /> estimated cost or eontract pr�ce for permit fee purposes. In the event that there is a dispute on #he <br /> amount af the job cosf, the Gity may request the submission of a signed copy of the actual contract. <br /> PLUMBING PERMIT APPLICATI�N AGREEMENT <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all vuork in <br /> s#rict accordance with the ordinances of the City and the regulations ofi the Stafe ofi Minnesota, and <br /> certifies that all statements made on this application are complete,true and correct. <br /> ���!„(����C',� ,�.'XI7��- Date: �� �� "� l� <br /> Applicant's Signature: r'�, <br /> $uilding Official/ Inspector: Date: <br /> Page 2 <br />