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— -- -__ _____ _�. <br /> -- __-- - - __�.._�, <br /> " ' ' PLUMBfNG FIXTURES BEING INSTA�LED ' <br /> —.__ - _ _ ------ ------_ -- _-- __ __ _--___--____ __ __ <br /> _...______ ______---- - __ .___ ---- ------__ <br /> ,-----,- __ <br /> - <br /> -- . . <br /> FIXTURE BSMT � ���1sr� 2"� i- OTHER � FI?CTURE ! BS�viT 1�� 2'`� ' OTI-f�R 1_ <br /> � TYPE � � Floor ' Floor t ' TYPE , Floor ; Floor I <br /> , ; <br /> � <br /> � � � � . _.__. _____ ._� ..._ ,.. _ <br /> _ _ _ __ __ i 4 _�___ ____.---� Floor Drams_.__�___!___ , _- � � <br /> � _ � �_..._�._ __� <br /> I Water Closet r ' ' i � <br /> � - � --_.__+__ , _ I <br /> ._.,_ <br /> ; � � _�- __ <br /> Lavatory � � i L� ' i Sewer E�ector I ' <br /> ��.. _ � � ' - '-- — , � <br /> , <br /> , ; -• ' ��.._ � <br /> ; Bathtub ( � � ; � Laundry Tray � <br /> � <br /> , � <br /> t------ --� -- ,-_____ <br /> —_�;—.. <br /> --.__- - <br /> 1 iv <br /> Shower ' _.__ _._�. <br /> ; � I ( ; Washer ; 1 j <br /> �_ __ 1___ _ _----_�_ !�� <br /> _,._� —_._ <br /> KitchEn Sink ( � j Water Neater � � � _ � � ; <br /> - - <br /> ____T <br /> , _ _.___ f <br /> _ _� � <br /> Disposal I � � ' Water Softener ' <br /> �—--- � --- , � <br /> _ .- _--- <br /> , � , _.___a._—_-____ _ __ – – — , <br /> I pishwasher � � � Wet Bar ' �; ' <br /> __� i �_ I � ; <br /> ; Silicocks � Z j � i Miscell�neous � �� <br /> � ' � i <br /> ��_ � , <br /> ---_.__��_._ _.._��.--- -�------- _------- � -- —�- - -1-- ---_.� <br /> __ _ ..�__._ __--- ---- ____ .. _ -- <br /> _ ___ __—____ --- <br /> __.___ ,�._ __._ _--- <br /> _��_ __ _ PEF�MIT FEE CALCULATION �� � <br /> __ - -----1 <br /> 1. CONTRACT PRICE * is 1.25% of contr�ct price with a (Minimum Fee of $5Q.00) <br /> �� • � x .0125 � <br /> (contract price) (minimum $5U.00} <br /> 2. STATE SURCHARGE <br /> x .0005 � <br /> (contract price) � <br /> 3. POSTAGE & HANDLING (Only on Mail-in Applications) � 2.00 <br /> l . c:� <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) g <br /> " CONTRACT PRICE or JOB COS7 means the actual or estimated doilar amount ch�rged for the <br /> permitted work including materials, labor, profit, and other fixed costs. It is the ar��ount to be charyed 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 �dded to the <br /> estimated cost or contract price for permit feE purposes. In the event that there is a dispute on the <br /> arr�aunt of the job cost, khe City may request the submission of a signed copy of the actual contract. <br /> - _ .�_. _ _ <br /> __ ___�. <br /> PLUMBING�PERMIT APPLICATIQN AGREEMENT <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to da all work in <br /> strict accordance with the ordinanees of the City and the regulations of the State of Minnesota, ar7d <br /> certifies that ail staterr�ents made on this applicatian are comptete, true and carrect. <br /> � <br /> Applicant's Signature: _ ----L.--.-, �w�.---� Date: _��' ��`� � �� __ <br /> E3uilding Official/ Inspector: Date: <br /> F�aye 2 <br />