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.'���'��Us�il'1tiA1 3 i i5 'rn i' � �5 �����k��T'S�IW�����°,r„"����i�"'t u'`'1�.�L,,,��,�:SayCn�.i�,
<br /> K� w^,.4Y 1 . �M1. S�i>ll f ,y.�i 9!t'4f
<br /> FIXTIJR� BSMT 1sr 2N� C7THER F(XTUR� BSMT 1�' 2�dD OTHER
<br /> TYP� Flaor Floor TYPE Floor Floor
<br /> Water Closet � Floor Drains
<br /> Lavatory , Sewer Ejector
<br /> Bathtub � Laundry Tray
<br /> Shower � Washer
<br /> Kitchen Sink Water Heater
<br /> Disposal I Water Softener �
<br /> Dishwasher Wet Bar
<br /> Silicocks i Mlscellaneous I
<br /> �
<br /> y��i�.��" :��i.�y..�.. . �i � . , ��. " Vs:� o �,r��ry �W.iTr�a-,r�,'r�+?^�r's+n"�'n ,C?,`"^�'�i„��,�y w'' .:;
<br /> ' � �u1�_�-"�.Lla�. .�a�,,,-,,..., .r,t,�4 Lracuc.��' s.�ti�d 18L'_::.
<br /> -,�,� a�v r,a�i ci�doi� ' ...... ... 'S � -�—,n-,.� ''-� ��'"�,v' �}
<br /> 1. C�NTRACT PRICE * is 1_25% of contract price with a (Minimum Fee of$50.00)
<br /> V�a��.��o� �� X .0,�5 �
<br /> (contract price) (minimum $50_Op)
<br /> 2. STATE SURCHARGE
<br /> x .000� �
<br /> (contrac�t price)
<br /> 3. POSTAGE & HANDLING (Onfy on Mail-In Appiic�tions) $ 2.00
<br /> per�}hp►'�
<br /> 4. TOTAL PERMIT FEE (Add �.ines 1-3 Above) $ ��• �� ,T, lQ��
<br /> " CONTRACT PRICE or J4B COST means the actual or estimated doilar amount charged for the
<br /> permitted work including materials, labor, pro�it, and ather fixed costs. It is the amo�mt to be charged to
<br /> the customer for the work done. If any material, equipment, labor or installations are fumished by the
<br /> owner, tenant or any ather party, the reasonable market value of such items must be added ta th�
<br /> estimated cost or cantract price far permit fee purposes. In the event that there is a dispute on the
<br /> amount of the job cost, the City may r�qu�st the submission of a signed copy of the actual cantract.
<br /> ����� �y- /� �+y ��
<br /> �'�'�3�a a>�1�'�'r,:���..�'C�;7" . Wa��;ia�� ;d ..�: .,,ti , ��1<•.791�1'�. .:t�`:..1� v.,_. �i � 7 cs�f t�tl��:
<br /> C.�S'mI�.S�..�c��'.�:�_��i'�� .UY�YL ...��.�. �__ `" I6.tlT I '1 1
<br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in
<br /> strict accorclance with the ordinances of the City and the regulations of the State of Minneso#a, and
<br /> certifies that all statements made on this application are complete, true and correct.
<br /> Applicant's Signature: ' Date: �/�o
<br /> Buifding Official/Inspector: Date:
<br /> Pa��z
<br />
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