Laserfiche WebLink
S e <br /> FIXTURE BSMT 1 2ND OTHER FIXTURE BSMT 1 <br /> TYPE Floor Floor -n,pE �OTHER <br /> Floor Floor <br /> Water Closet a Floor Drains <br /> i <br /> I Lavatory Sewer Ejector <br /> Bathtub <br /> ( Laundry Tray <br /> Shower ( Washer <br /> Kitchen Sink Water Heater <br /> Disposal <br /> Water Softener <br /> Dishwasher Wet Bar <br /> Silleocks Miscellaneous <br /> HIM <br /> 1. CONTRACT PRICE *is 1.25% of contract price with a (Minimum Fee of$50,00) <br /> --- � 1:�K 60x .o�2s $ 7y,9' <br /> 2. STATE SURCHARGE (contract price) (minimum$50,00) <br /> `S ?9'.Ob x.0005 $__ <br /> (contract price) .-- <br /> 3. POSTAGE&HANDLING (Only on Mail-in Applicatlons) $ — 2,00 <br /> 4, TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <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 famished 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 orf the actual contract. <br /> 41;0111111 <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 ara,00mplete, true and correct. <br /> Applicant's Signature: ,,�J ite.* 1I � <br /> Date. <br /> Building Of iciaU Inspector: <br /> Date: <br /> Page 2 <br /> Z 96ed 690E998ZI,9 xed dH Wd95:E0 8LOZ SZ Uel <br />