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� <br /> � • ,� <br /> ` PLUN�Bt�FF�'�, . . ,-. ., .N� lh1�TA�:�:��.. <br /> FIXTURE BSMT 1sr 2ND OTHER FIXTURE BSMT 1sT 2ND OTHER <br /> TYPE Floor Floor TYPE Floor Floor <br /> Water Closet , � Floor Drains � <br /> Lavatory �+ '?� Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower �' f Washer <br /> Kitchen Sink Water Heater t <br /> Disposal Water Softener <br /> Dishwasher ' Wet Bar <br /> Sillcocks � Miscellaneous <br /> , „, � <br /> , �., , ,�•.;: <br /> ��.,: , „� 3��.. ���A�`�.�'EE �ALCUL�A�I y.. � �� ' <br /> ' �.:�. � <br /> n�... <br /> 1. CONTRACT PRICE '' is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> �7 /r� �/'��� x .0125 $ `� ����� <br /> -�(contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> �/������� x .0005 $ '7. �.a� <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) $ l� /���7� <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 /> : ;. : . .��.�J11�B#t�L��?�F��tItT�1,`, ��E�A�'I �A+�R�E�IIF�T <br /> ; <br /> �� ... <br /> �. <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 made on this application are complete, true and correct. <br /> c^ i <br /> ApplicanYs Signature: Date: 1 v? o� <br /> Building Official/ Inspector: Date: <br /> Page 2 <br />