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61/05/2018 06:11 7632592299 SCHULTIES PLUMBING PAGE 08/11 <br /> FIXTIJRE BSMT 1sT ZND pTHER FIXTURE BSMT 18T 2ND OTH�R <br /> 1�'� Fioor Floor T1'PE Floor Floor <br /> Water Close# � � Flaor Dralns f <br /> Lavatory � Sewer Ejector <br /> Bathtub l Laundry Tray i <br /> Shower Washer <br /> Kltchen Sink � Water Heater � <br /> Disposal f Waber Softener <br /> Dishwesher Wet Bar � <br /> Sillcocks � Miscellaneous <br /> 1. CONTRAGT PRlC� *is 1.25�6 af cor�tract price with a(Minimunn Fee of 550.00) <br /> � " .�'�/��Da �x .o�as � <br /> (con#ract price) (minimum�50.00) <br /> 2_ STATE SURCHAFtGE <br /> ������ x_QQ05 $ <br /> (cantract price) <br /> 3. POSTAGE� HANDLING (Only on Mail-In Applica#ions) $ 2.p0_. <br /> 4. TOTAL hERMIT FEE (Add Lines 1-3 Abave) s !�� <br /> ' CONTRACT PRICE or JOB CQST means the actual or estimated dollar amount charged for the <br /> permitted wark incfuding materials, labor, profit, and o#her fixed costs. It is the amouni to be charged to <br /> the customer for the work done. If any material, equipment, labor or installa#ians are fumished by the <br /> own�r, tenant or any other party, the reasonable market vafue of such items nnust be added #o the <br /> � estimated cost or cantract price for permit fee purposes. ln the even# that there is a dispute an the <br /> amourrt of the jvb cost, the City may request #he submission of a signed copy of the actual contract. <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do ail work in <br /> strict accordanoe wrth the ordinances of the City and the regulations of the State af Minnesota, and <br /> cefifies that all statements mad application are complet�,true and carrect. <br /> Applicant's Si nature'°�.1/ Dafe: /�� +��5 <br /> 9 <br /> Buifding Otficial/Inspector: Date: <br /> P�pe 2 <br />