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. • <br /> ��. ..�v.. �` : .,;�. . PLt� ` ����Tl,���..:...���� ��.�TALL��..�,�- , k y � <br /> FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1sT 2ND OTHER <br /> TYPE Floor Floor TYPE Floor Floor <br /> Water Closet / Floor Drains � <br /> Lavatory Sewer Ejector <br /> Bathtub I Laundry Tray r <br /> Shower � � Washer / <br /> Kitchen Sink � Water Heater / <br /> Disposal Water Softener <br /> Dishwasher � Wet Bar � <br /> Sillcocks � Miscellaneous <br /> PERMIT FEE �ALCULATION' <br /> 1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> �/J(��'.��� x .0125 $ l 5' 7 S� <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> �'i ���C:)��� �� <br /> .� X .000s � � -� U <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 /> ' � ' :: ; P�.iJ�IB1NG PERA�I�T�1��.��ATI��:,.., . ' E�T <br /> ;,., <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 Signatur� Date: � 1 � <br /> Building Official/ Inspector: Date: <br /> Page 2 <br />