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Stewart Plumbing, Inc. 7634281733 p.3 <br /> s • . <br /> PLUMBING FIXTURES BEING INSTALLED <br /> FIXTURE BSMT 1sT 2 N OTHER FIXTURE BSMT 1s' 2N° OTHER <br /> TYPE Floor Floor TYPE Floor Floor <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathtub ( Laundry Tray 1 <br /> Shower 1 j Washer <br /> Kitchen Sink Water Heater J <br /> Disposal Water Softener <br /> Dishwasher , Wet Bar <br /> Sillcocks <br /> Miscellaneous c5 <br /> PERMIT FEE CALCULATION <br /> 1. CONTRACT PRICE *is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> 9q!5,6 0 x .0125 $ Ll 19. -�3 <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE /� n <br /> 31 q-1,5.00 x.0005 $ / %/ / <br /> (contract price) <br /> 3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 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 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 /> PLUMBING PERMIT APPLICATION AGREEMENT <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 /> Applicant's Signature: 'Y` I"" CS Date: 11-1-7-1-7 <br /> Building OfficiaV Inspector. Date: <br /> Page 2 <br />