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Mar 11 1� 10:23a Water poctors 7635351805 p,2 <br /> � :_'; "_. - : �LL1�VI81NG FtXTt�R�S B€��1�INST�LLED ., ; <br /> FIXTURE , BSMT 1sT 2"o OTHER FIXTURE BSMT 1sT 2ND pTHER <br /> TYPE Floar Floor TYPE Floor Floor <br /> 1Nater Closet , Floor Drains I <br /> Lavatory � Sewer Ejector <br /> Bathtub i Laundry Tray <br /> 5hower Washer <br /> Kitchen Sink Water Heater <br /> ' Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sil Icocks ' Miscellaneous <br /> ' , F'�f�MfTfE� GAi.C�1LAT[D�J. . . ' <br /> 1. CONTRACT PRICE *is 4.25% of contract price with a(Minimum Fee of$50.00) <br /> �^� x .0125 � <br /> (contract price) (rninimum $50.00) <br /> 2. STATE SURCHARGE <br /> x .0005 $ <br /> (contract price) <br /> 3. POSTAGE�HANDLING(Only�n Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Abovej $ <br /> " CONTRACT PRICE or JOB COST means the actual or estimaied doflar amount charged for the <br /> permitted work including materials, labor, profit, and other fxed 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 o�er party, the reasonable market value of such items must be added to the <br /> estimated cost or contract price for permit fee purposes. I� the event that there is a dispute on the <br /> amaunt of the job c�st, the City may request the submissian of a signed copy of the actual contract. <br /> P�UNIBENJ� PERAtItT APPL1£',ATION l�k,GREERIlENT - <br /> The undersigned hereby appfies to the City for issuance of a Plurr�bing 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 /> certifes that all statemenfs mad on this appli re mplete,true and correct. <br /> Applicant's Signature: Date: <br /> Buildir�g OfficiaU Inspector: Date: <br /> Page 2 <br />