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Jan 29 16 01:56p Water poctors 7635351805 p.2 <br /> ! � i i <br /> - <br /> ` PLUMBING FIXTURES BEING INSTALLED T� <br /> FIXTURE BSMT 15T 2"o OTHER FIXTURE BSMT 1ST 2ND �THER <br /> TYPE Floor Floor '', TYPE Floor � Floor <br /> Water Closet Floor Drains <br /> �avatory Sewer Ejector <br /> B2thtub I Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> �isposaJ Water Softener � <br /> Dishwasher Wet Bar <br /> Sillcoc�cs Misceilaneous <br /> _ PERMIT FEE CALCULATION <br /> 1. CONTRACT PRICE ' is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> x .0125 $ <br /> (contract price) (minirrrum $50.00} <br /> 2. STATE SURCHARGE <br /> x .0405 $ <br /> (contract price) <br /> 3. POSTAGE 8 HANDLIMG (Only on Mail-In Appiications) $ 2.00 <br /> 4. TO7AL PERMIT FEE (Add Lines �-3 Above) $ <br /> ` CON�RACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor, profit, and other fixed cosis. It is tF�e amount fo 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 vafue of such items musf be added to the <br /> estimated cosf or contract price for permit fee purposes. In the event that there is a dispute on the <br /> ameunt of the job cost, the C�ty may request the submission of a signed copy of the actual contract. <br /> (�-_T PLUMBING PERMIT APPLtCATION AGREEMENT _ <br /> - - � <br /> 7he unclersigned hereby appiies 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 /> certifes that all statements made on this ap lication re complete, true and correct. <br /> ApplicanYs Signature: �� Date: <br /> Building Official/ InsAector: Dafe: <br /> Page 2 <br />