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���' _ �` � _ � � P�,UMBING FIXTURES-BEING�INSTALLED` -��: _�� p �, = _��-�.°���:�,��6-,� <br /> , _ . _---.— ---- ___. __�.____._ _ <br /> FIX1"URE BSMT 1�� ( � ?r�� � (�THER FIXTl1RE BSMT ' '1�� 2""' OTHER <br /> TYPE Floor " Floor TYPE Floor Floor <br /> � <br /> i <br /> r----- ...___ __. <br /> Watcr Closet f � � Floor Drains iW �� � � �j-��i�j�L. <br /> —_.___ _........__________� �_____---_ .__ / <br /> Lavatory � � S�wer Ejector <br /> Bathtub � � Laundry Tray l <br /> Shower �:�� � Washer � <br /> `' ----- __ -- <br /> Kitch�n Sink � Water Heater � <br /> .�_. _ _ �.._._�. __ _. _ � <br /> Disposal J Water Softener <br /> Uishwasher � Wet Bar � / � <br /> ------ �----- ---- - <br /> Sillcocks � �� Miscellaneous <br /> _..�_.._..... .__L_.....� _.. . ..... :_____.... _ <br /> � . , . <br /> � �`� ���PERMIT�FEE CALCI�LATION :u�a_��� ,��°� '� ' ` �=����: <br /> 1. CONTRACT PRICE ' is 1.25% of contract price with a (Minimum Fee af 550.00) <br /> � <br /> �v �- <br /> ���- , �%����; x .0125 � � `���- • , ,. <br /> (contract price) (minimum 550.00} <br /> 2. STATE SURCHARGE % <br /> ��, <br /> , <br /> � � ,�� �� <br /> � <br /> � <-- � � � x .000� $ �% � <br /> {contract price} <br /> 3. POSTAGE 8� HANDLING (Oniy on Mail-In Applications) � 2.00 <br /> .-� <br /> l� <br /> 4. TOTAL PERMIT FEE {Add Lines 1-3 Above) 5 �\�� 1 <br /> ' CONTRACT PRICE or JOB COST means the actuai or estimated dollar amount charged for the <br /> permitted work incl�ding materials, {abor, profit, and other fixed costs. It is the amount to be charged to <br /> the customer for the work done. If any m�terial, equipment, labor or installations are furnished by the <br /> owner, tenant or any other party, the reasonable market value of such items must b� added to the <br /> estimated cost ar contract price far permit fee purposes. In the event that there is a dispute on the <br /> amount af the job cast, the City may request the submission of a signed copy of the actual contract. <br /> _ __ �_.__.._ ___�_ .__ , .. <br /> �� �` " ����PLUMBING�PERMIT�APPLI_CATION AGREEMENT '���' `"` � � � a�� -��:� <br /> � ` �_ __ __ � __ _-- - -- <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 regulatians of the State of Minnesota, and <br /> certifies that all statements made on this applicatinn are complete, true and correct. <br /> Applicanfs Signature: l' vl� � �-- G�`'6`L Date: � , 1� �� <br /> Building Official/ Inspector. __ Date: �___.___._._,. <br /> Page 2 <br />