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�N!C�(�1S.TALLEt��,.� ������y";�`�A. � ��� ' ��.: <br /> �����' ,�,;,�"�'��0.�-�`�,�,��..P�U1�711�ING FIXTURES,�BE. ,� �w �,� _ °_ }� <br /> � � � <br /> FIXTURE BSMT 1sT 2ND pTHER FIXTURE BSMT Floor Floor OTHER ,� <br /> TypE Floor Floor TYPE <br /> Water Closet Fioor Drains <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener � <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> �; '& ,.�i• � 't Y ,K �'.�rit� ��,�-��-L ���;�'1�'�e`�-�'�4,,�`,m,; <br /> �.+4, �y°`'",��," . �s"� .t;; �t: ���vi'a »,�- ,v .,,�.. :.4:s-. <br /> 3 �+i"„�'� �' 4... <br /> mr2#'�,-. �as <br /> 1. CONTRACT PRICE " is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> �bs� x .0125 $ <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> x .0005 $ <br /> (contract price) <br /> 3. POSTAGE 8� HANDLING (Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ <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 furnished 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 /> � {'� 1�� �� l���'.�'�1:.���A'���...�.. � .-� t `� z�� �����°�� ������. <br /> wi 7. <br /> s�«. � f� *�s �. �Ir,` �: � � ��r, �,�•.. <br /> s . <br /> � <br /> a�8 ��a,z`��n, <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 statements made on th,is application are complete, true and correct. <br /> � /.._._1 — -- - <br /> ._._../,_ - _�'���_ Date: S�10��-7 <br /> ApplicanYs Signature---`""� <br /> Building Official/ Inspector: Date: <br /> Page 2 <br />