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ti � • <br />. �:Pl»U�8#1�� FiX .#�E5 B�IMC �1��'fA�,.�..�i3 <br /> FIXTURE BSMT 1sr 2ND OTHER FIXTURE BSMT 1sr 2ND OTHER <br /> TYPE Floor Floor TYPE Floor Fioor <br /> Water C�oset � a a Fioor Drains � ' <br /> Lavatory � 3 Sewer Ejector <br /> Bathtub � Laundry Tray � <br /> Shower t � � Washer � <br /> Kitchen Sink � Water Heater � <br /> Disposal � Water Softener � <br /> Dishwasher I Wet Bar <br /> Sillcocks y Miscellaneous <br /> �����T� � ��.�ut.�r�a� <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a (Minimum Fee of$50.00) <br /> 3 1 � �5 - � � x .0125 $ � ./�� �' � <br /> . <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> 3`f. � 7 �'. (� X .000s $ 1 7. �-I �l <br /> (contract price) <br /> 3. POSTAGE � HANDLING (Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) , $ ` S��• 3 6 <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 fumished 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 /> PLU� i{wiG PEF�I1�t'�Af', LlGATl+ON��Ft�F..AItEiVT , ° ' °, <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 statement ade on this application are complete, true and correct. <br /> Applicant's Signature: �- �- Date: a"I a � II � <br /> Building Official/ Inspector: Date: <br /> Pege 2 <br />