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NOV/Ci;2016/�ON 09: 11 AM Heating & Cooling 2 FAX No, 7634283677 P, 003 <br /> FIXTURE BSMT 1sT 2"o OTHER FIXTURE BSM7 15T 2"D OTHER <br /> TYPE Floor FEoor 7YPE Floor Flovr <br /> Water Closet Floor Dralns <br /> Lavatory Sewer Eector <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heat�r <br /> Dlsposal Water Saftener <br /> Dishwasher Wet Bar <br /> Sillcocks Mlscellaneous <br /> 1. CONTRACT PRlC� "'is 9.25%of contract price with a(Minimum Fee of$50.00) <br /> (� C � x .0125 $ <br /> (contract price) (minimum $5Q.o0) <br /> 2. $TATE SURCHARGE <br /> x .0005 $ <br /> (contract price) <br /> 3. POSTAGE 8� HANDLING (Qnly on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMET F�� (Add Lines 1-3 Above) $ <br /> � CONTRACT PRICE or JOB COST means the actual or estlmated dolfar amount charged for the <br /> permitted wark including materials, labor, pro#it, and other fixed costs. ft is the amount to be charged #o <br /> the customer for the wark 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 musf be added to the <br /> estimafed 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 o# a signed capy af the actual contract. <br /> The und�rslgned hereby applies to the City for issuance of a Plumbing Permit, agrees to d� aU work in <br /> strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and <br /> certifiies that all statements made on this appfication are complete,true and correct. <br /> Applicant's Signature: bate: /`" �f� <br /> Building Official/Inspector: Date: <br /> Page 2 <br />