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� ...� � _. <br /> ; <br /> z . ' <br /> ; <br /> ` Pl�l1fi�F�1N�F#XTURES BE#NC3 tNS"CA�::E.,�O <br /> t=1XTURE BSMT 1ST 2"D QTHER FIXTURE BSMT �ST 2ND OTHER <br /> TYPE Fioor Floor TYPE Floor Floor <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> ' Disposal Water Softener <br /> Dashwasher Wet Bar <br /> Sillcocks MisceUaneaus <br /> � � PER�T'FEE C1�1�.Ct,1L.Al`ti7N ` <br /> ; 9. CONTRACT PRlCE ""is 1.25%of cantract price with a(Minimum Fee of$50.00) <br /> x A125 $ `-�� <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> i x.0005 $ ��-� <br /> ' (eontract price) <br /> 3. POSTAGE&HANDLING (Qnly an Maii-tn Applications) $ 2.00 <br /> ; 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ >� d 2"� — <br /> � <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 ta be charged to . <br /> the customer for the worfc done. If any material, equipment, labar or instaitations are fumished 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 cantract price for permit fee purposes. fn the event that there is a dispute on the <br /> amount af the job cost, the City may request the submission of a signed copy of the ac#ual contract. <br /> P�UMBING PERNIIT APP�ICATIUN AGRE�MENT � <br /> The undersigned hereby applies to#he City for issuance of a Plumbing Permit, agrees to do atf work in <br /> strict accordance with the ordinances of the City and the regutations of the State afi �flinnesota, and <br /> certifies that ail statements made on this appticatian are complete, true and correct. <br /> Applicant's Signature: �/� �" Date: v �� �� <br /> Building OffciaU{nspector: ��E� <br />