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• <br /> . � <br /> x� ,�� �, :::� � ����� ..� ��..�. <br /> FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1sT 2ND OTHER <br /> TYPE Floor Floor TYPE Floor Floor <br /> Water Closet �' Floor Drains � <br /> Lavatory � Sewer Ejector <br /> Bathtub � Laundry Tray <br /> Shower l Washer <br /> Kitchen Sink Water Heater � <br /> Disposal � Water Softener <br /> Dishwasher Wet Bar 1 <br /> Silicocks � Miscellaneous <br /> %', a.: y `-�: �" �r �w6 �,j/�� -:s- ��^ ' ., � �::F QRy�i � l ���C a�-. <br /> . . h. ..-- t5 yi, ro r y l�' � ;5: . �i �'� S � '1��� <br /> , .. <br /> „•, �, <br /> .w�� a :�v:.', 4+�n„..:a.�. ,,,, �� .,.i - ,s,, E y. ,�..a. <br /> 1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> �j � x .0125 $ ��(o •�� <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> �` T, �� x .0005 $ �' /S <br /> (contract price) <br /> 3. POSTAGE � 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 /> ,. . .... <br /> � � � .. <br /> , <br /> ���-� _. � ��� ..,: x: ,: . - ., ,����� ,. � <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 regulations of the State of Minnesota, and <br /> certifies that all statements made on this application are complete, true and correct. <br /> Applicant's Signature Date: S!/ � �/�-'J� <br /> Building Official/ Inspector: Date: <br /> Page 2 <br />