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Y � ~ Fr m Heating and Cooling Two 1.763.428.3682 Tue Sep 19 10:56:26 2017 MDT Page 2 of 2 <br /> , FI . llRE BSMT 1sT 2ND OTHER FIXTURE BSMT 4ST 2"D OTHER. <br /> PE Floor Fioor TYPE Floor Ffoor <br /> Wate Cioset Floor Drams <br /> Lavat ry Sawer Ejector <br /> 8atht b Laundry Tray <br /> Show r Washer <br /> Kitche Sink Water Heater � <br /> Dispo al Water Softener <br /> Dishw sher Wet Bar <br /> Sificoc s Miscellaneous <br /> 1. CONTRACT PRICE k is 1.25%of contract price with a (Minimum Fee of$50.00) <br /> `�"c�fl` � x .0125 $ � ✓�'�J <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> r�'-3�{��� x .ao�s $__ �� �� <br /> (cantract price) <br /> . POSTAGE&HANDLING (Onty on Nlail-In Applications) $ 2.00 <br /> . TOTAL PERMI'�FEE (Add Lines 1-3 Above) $ �� �� <br /> " CON RACT PR(CE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitt d work including materials, labor, proft, and other fixed costs. It is the amount to be charged to <br /> the cus. mer for the work done. If any material, equipment, labor or installations are fumished by #he <br /> owner, enant or any other parfy, the reasonable market value of such items must be added to the <br /> estimat d cost or contract price for permit fee purposes. In the event that there is a dispute on the <br /> amount f the job cost, the City may request the submission of a signed copy of the actual contract. <br /> The und rsigned hereby appiies to the City for issuance of a Plurnbing Permit, agrees to do all work in <br /> strict ac ordance with the ordinances f the City and the regulations of the State of Minnesota, and <br /> certifes at ail statements de on application ar complete, true and correct. <br /> Applican 's Signature: � Date: �� ��(�,�� <br /> 8uilding fficial/Inspector: Date: <br /> Page 2 <br />