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, . Stewart Plumbing, Inc. 7634281733 p.2 <br /> PLURABING FlXTURES BEING INSTALLED <br /> FIX7URE BSMT �sr 2ND OTHER FIXTURE BSMT '!ST 2ND OTHER <br /> TYPE Floor Floor TYPE Floor Flaor <br /> Water Closet � � Floor Orains <br /> Lavatory � � Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower Wasfi�er ( <br /> Kitchen Sink , Water Heater � <br /> �isposal ' Water Sflftener <br /> Dishwasher Wet Bar <br /> Sillcocks � Miscellaneous <br /> PERMIT FEE CALCULATI(3N I <br /> �E. C�NTRACT PRICE "'is 1.25% of contract price with a{AAinimum Fee of�50.00) <br /> ��a.Go�.nn x.a�z5 $ ��f� aS <br /> �(contract price) (minimum$50.00) <br /> 2. 5TATE SURCHARGE <br /> ` x .0005 $ /a� �-� <br /> (contract price) <br /> 3. P�STAGE 8�HANDLING (Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above} $ ��3• �� <br /> * CONTRACT PRICE or JOB COST means the actual or estimated dallar amount charged for the <br /> permitted woric including materials, labor, profit, and other flxed costs. It is the arnount to be charged ta <br /> #he customer for the work done. If any material, equipment, labor or installafions are furnished by the <br /> owner, tenant or any other party, the reasonable market val�e of such items musE be added t� the <br /> estimated cost or contract price for permit fee purposes. In the event that tt�ere 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 /> PLUMBING PERMIT APPLICATION AGREEMENT <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees ta do all work in <br /> strict accordance with the ordtnances of the City and the regulations of the State of MEnnesota, and <br /> certifies that all statements made on this applicai�on are complete,true and correct. <br /> ApplicanYs Signature: ��/ �t-�'C� � `Xf n" Date: �l y'"�� <br /> Building Official!Inspector: Date: <br /> Page 2 <br />