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FROM:TO:D522494616 01/20/2016 00:48:30#24338 P.002/002 <br /> � <br /> . „. _ <br /> ��,,,� ;� PLUMBlNG FIXTURES BEING (NSTALLED � <br /> ._ _.�...� � <br /> FlXTURE BSMT 15� �2ND OTHER mm� FIXTURE ���'�W 6SMT 1sr �No d�j::��R <br /> TYP� Flnor Floor TYPE Floor �'loar <br /> Water Closet �� Floor brains Mx� �.� M� <br /> Lav�tory ✓ Sewer Ejector � <br /> .... ,.�. .�...� ..._.„ ..�.. <br /> Bathtub Laundry 7'ray <br /> ..�,..... .....,. <br /> � <br /> Shower ,� Washer <br /> ...,_ �..�..._ <br /> ,,,,_. �,,,,. <br /> Kitchen Sink Water Heater <br /> bisposal Water Softener W �� <br /> .��.� __.,.. <br /> Dishwasher , Wet Bar <br /> _.�.,... _ _......... ..._�. <br /> 5illcpcks Miscellaneous �j <br /> PE�2MIT FEE CALCULATIUN <br /> 1. CONTRACT pRICE " is 1.25% of contract prfce with a (Minlmum Fee af 554.00) / �� <br /> 2�? �7� � � <br /> ���' ~ x .012 5 � � �j 1. �. ,n <br /> (contract price) (mi�imum �50:��) <br /> 2, STATE SURCHARGE <br /> ��`''�' � x .0005 $ �• � � <br /> (contract price) <br /> 3. P05TAGE� HANDL,ING (Oniy on Mail-In Applications) $ Z.00 <br /> , �5 � <br /> 4. TQTAL P�RMfT FEE (Add Lines 1-3 Above) $ � �� _ -- <br /> " CONTRACT PRICE or .306 COST means the 2�ctual or �stimated dqll�r amount charged for the <br /> permitted work including materiais, labor, pr�fit, and o#her fix�d costs. It is the amount tn be charged to <br /> the customer for the work done. If any material, equipment, labor pr instaUations are furnished by the <br /> owner, tenant or any other party, the �easonable rrcarket value of such items must be added to fhe <br /> estimated cost or coniract price for permi# f�e purposes. In the event that there is a dispute pn the <br /> amount of the job cost, the City may request the submission of a signed copy of the actual contract, <br /> � PLtJMBiNG P�RMiT APPLICATIQN AGREEMENT � <br /> 7'he undersigned hereby applies to the City fvr issuance of a Plumbing Permit, agrees to do all work in <br /> strict accprdance with the ordinances of the City and the regula#ions of the Siate nf Minnesota, and <br /> certifies that all statements made on this pplication are complete, true and correCt. <br /> Applicant's 5ignature: Date: ����"'�`� <br /> Building Official!Inspector: Date: <br /> F'A9e 2 <br />