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PLUMBING FIXTURES BEING INSTALLED <br /> FIXTIJRE BSMT 1sT 2ND OTHER FIXTURE BSMT 1sT 2ND OTHER <br /> TYPE Floor Floor TYPE Floor Floor <br /> Water Closet � ; Floor Drains <br /> Lavatory t..� Sewer Ejector <br /> Bathtub I L- Laundry Tray � <br /> Shower Z. Washer ! <br /> Kitchen Sink J� Water Heater { <br /> Disposal Water Softener <br /> Dishwasher � Wet Bar ( <br /> Sillcocks 2..- Miscellaneous <br /> PERMIT FEE CALCULATION <br /> 1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00)�3�3 , 7S <br /> ��'/ �OC� .0125 $ <br /> _ (contract price) (minimum $50.00) <br /> 2. $�ATE SURCHARGE l � �v� <br /> � x .0005 $ � � �� <br /> (contract price) <br /> 3. POSTAGE & HANDLING (Only on Mail-In Applications) $ 2.00 <br /> � � � <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ �� <br /> * CONTRACT PRICE or JOB COST means the actual or estimated doliar 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 far 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 <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 dina es of the City and the regulations of the State of Minnesota, and <br /> certifies that all statement m de rj this ap ic ion are complete, true and correct. <br /> � <br /> ApplicanYs Signature: Date: �r� l <br /> Building Official/ Inspector: Date: <br /> Page 2 <br />