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FROM :American Mechanical FAX N0. :763 477 4085 Mar. 02 2016 08:07AM P2 <br /> . <br /> '-' � .=`�a`�'`:�; ,�!,u;��Y;,:3��;.,�,: �' <br /> ,�, <br /> FIXTURE SSMT 1 sT "2"0' OTHER FIXTURE BSAAT 'I sT zND OTH�f� <br /> TYPE Flbor Fbor TYPE Ffoor Fbor <br /> Water.�{i� � � F{ovr.Dr.a�ns. � <br /> Lavatery ( � Sewer Ejedor <br /> ���b Laundry Tray �' <br /> Shower t � Washer � <br /> ��'+en 9i� � Y��a� � <br /> Dispv�I � `�4f.ater Softerter <br /> Dishwasher � Wet Bar � <br /> Sillcocks Misceltsneous <br /> � <br /> 1. CONTRACT PR E * is 1.25%of contract price with a (Minimum Fee of 550.00) <br /> ���� ,_x.0125 $---�� � <br /> (contract price) (minimum $50.00) <br /> 2. .STATE SURCHARGE <br /> �L GUU �.oaas � �r <br /> ��� <br /> 3. POSTAGE 8� HANDLING (Only on Mail-In Apptications) $ 2.00 <br /> 4. TpTA�PERMIT FEE(Add Lirres 'E-3 Abav�j s �_ r � <br /> * GO�NTF2A�T Pf210E or J4B CQST means the� ac;tuai or estimate�d doNar amaunt charg�d fc>r th�: <br /> permitted work 'tncluding materials, labor, profit, and other fixed costs. lt is the amount to be charged#o <br /> #he customer for the work done. ff any material, equipment, labor or installafions are fumished by the <br /> owner, tenant or any other party, the r�asonable market vaiue of such items must be added to the <br /> estimated cost or contract price for permit fee purposes. In the event thaE 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 /> �}.;�. :. <br /> n <br /> The undersigned hereby appliss to the City for issuance of a Pfumbing Permit, agrees to do all work irt <br /> strict accordance with ordinances of the City and the regulations of the State of Minnesot�, �nd <br /> certfies that atl state n m o his application are complete,true and correct. <br /> App�nt's Spgnature: �; ,��J�(� <br /> Building Offici�f/Inspector: Date: <br /> Pag�2 <br />