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. " , <br /> �_ PLUMBING FIXTURES BEING INSTALLED --) <br /> � <br /> � FIXTURE BSMT 1sT 2ND OTHER FIXTURE i BSMT 1sT 2"o OTHER <br /> ' TYPE Floor Floor TYPE Floor Floor <br /> Water Closet Floor Drains � <br /> ', Lavatory Sewer Ejector � <br /> ' Bathtub Laundry Tray <br /> �r . <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener I <br /> , Dishwasher Wet Bar <br /> I Sillcocks Miscellaneous , <br /> PERMIT FEE CALCULATION � <br /> 1. CONTRACT PRICE * is 1.25% of contractpr�ice with a (Minimum Fee of$50.00) ��; <br /> � J C.���' �t, x .0125 $ ���'�, <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE ` <br /> x .0005 $ <br /> 'l� <br /> (contract price) <br /> 3. POSTAGE & HANDLING (Only on Mail-In Appiications) $ 2.00 <br /> l ��� <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 /> PLUMBING PERMIT APPLICATION AGREEMENT <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 omplete, true and correct. <br /> Applicant's Signature: Date: � �� <br /> Building Official/ Inspector. Date: ` �� <br /> Page 2 <br />