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5/25/2016 7 : 32 AM FROM: 9524914307 TO: +19522494616 P. 3 <br /> � i P�UMBING FIXTURES BEING INSTA�LED <br /> FIXTURE BSMT 1sr 2ND ', OTHER FIXTURE BSMT �ST 2ND OTHER <br /> TYPE Floor ' Floor i TYPE Floor Floor <br /> Water Closet � 2 ' Floor Drains <br /> Lavatory � � Sewer Ejector <br /> Bathtub � , Laundry Tray <br /> Shower Washer <br /> � Kitchen Sink Water Heater <br /> � Disposal , ', Water Softener ' <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> _.-- -- --- -- —__ _ _ _ - - --- - _--- <br /> PERMIT FEE CALCULATION <br /> 1. CONTRACT PRICE " is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> � l i } ;,, <br /> .� ,!�� �� x .0125 $ <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> x .0005 $ <br /> (contract price) <br /> 3. POSTAGE 8� HANDLING (Only on Mail-In Applications) $ 2.0� <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 /> [ PLUMBING PERMIT APPLiCATION AGREEMENT I <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 lhal al! slalements made on lhis application ar�,..{;ornplete, lrue and correcl. <br /> ,-�:.� / �,���'/`�,'' <br /> Applicant's Signature: <br /> ��rf,!��.�!'�- 1'��,f'`2��'. Date: 5/25/2016 <br /> Building Official! Inspector: Date: <br /> Page 2 <br />