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Mar.07.2017 10:57 AM Tiger Plumbing Heating an 9529745164 PA6E. 1/ 1 <br />. � <br /> __. PLUMBING �IXTUftES BEING INSTAL[.ED � �., � <br /> �IXTURE BSMT 1sT 2"0 07W�R � �FIXTURE BSMT 18T 2"° OTHER <br /> NPE Floor Floor TYPE Floor �loor . <br /> Water Closek Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathtub l.aundry Tray <br /> Shower Washer <br /> Kitchen Sink ✓ Water Heater <br /> Disposat ✓ Water Softener � <br /> Dishwash�r Wet Bar <br /> Sillcocks . AAiscella�eous <br /> . . <br /> , , :PE�tMiT FE����ULAt1�N .. :. . ..:: , „ : . <br /> 1. CONTRACT PRICE ' is 1.25%of contract price with a (Minimumi Fee of S50.Op) <br /> � x .0125 $ o��, �S ��G,.�� �'l�n <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> X � � �° x ,OOo5 $ ,� � <br /> (contract price) <br /> 3. POSTAGE�HANQ�,iNG (Only on Mail-Irt Applications) $ 2,pp <br /> 4. TQTAL PERMIT FEE (Add Lines 1-3 Abovg) � �Q '�� <br /> * CONTRACT PR1C� or JOB COST means the actual or estim�ted dollar arnount charged for the <br /> permitted work including materials, labor, prpfrt, and other fixed cpsts. It is the amount to be charged to <br /> the customer for the work donP. If any matpria�, Pr�i iirmwnf lahnr or instalfations pro fumished by the <br /> owner, tenant or any other party, the re�sonable market vafue of such items must be added to the <br /> esEimated 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 PERMITAPPLICATIQN ACRE�M�NT.::.��'; =: .:°:;�:,: ,>:, :; : ,_:.': <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do a!I work in <br /> strict �ccordance with the ordinances of the City and the regulations of the 5tate of Minnesot8, and <br /> certifies that all statements rCiade on this application are complete, true and correct. <br /> Applicant's Signature: �-�'� - �''��� Date: '� )�� <br /> C.-''� <br /> Suilding Official/Inspector: Date: <br /> Page 2 <br />