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a � <br /> , . . _; <br /> � <br /> �:: �` � ; ' '��� c ;.�� ,,,,: ' ; ,, � . � � �`���'�,s.�-; ���4"+q�^,7 vh{ s r-4�� <br /> . �_, ., , • , -� >� . ..,. <br /> . ._ ,- . . . , .:. .;... .� _ .. . . ..,. . . . „�. ...,� <br /> ...... .� .. ,.. ....;: .. . ��. .... ._. <br /> • � <br /> FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2"D OTHER <br /> TYPE Fioor Floor TYPE Fioor Floor <br /> Water Closet � Floor Drains <br /> Lavatory a Sewer Ejedor <br /> Bathtub Laundry Tray <br /> Shower Washer ` <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillc�dcs Miscellaneous <br /> '�.. ,.�-'�F� i•�,,, lb f /k fi�4 1 <br /> 1. CONTRACT PRICE 'is 1.25%of cor�trract price with a(Minimum Fee af�5Q.00) <br /> �,.� , S db, � x .0125 $ <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> x.0005 $ <br /> (c�ntract prioe) <br /> 3. POSTAGE�HANDLING (Only on Mail-In Apptications) $ 2.00 <br /> 4. TOTAL PERMR FEE(Add Une.s 1-3 A�ve) s <br /> * CONTRACT PRICE or JOB COST means the aCtual or estimated dollar amourrt cha�ged f� tF� <br /> permitted wo�ic including materials, labor, profit, and other fixed costs. It is the amount to be charged to <br /> the customer for the work dor�. If any material, equipment, labor or installations are fumished by the <br /> owner, tenarrt or any other party, the reasonable market value of such items must be added to the <br /> estimated cost or contrad price for �it fee pu�Oses. 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 oopy of the actual contract. <br /> , F�t. _ ;,, �` , ` <br /> The undersigned hereby applies to the City for issuance of a Plumbing Pem�it, agreeS to do all work in <br /> strict acxordance wi� the ordinanoes 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 /> ApplicaM's Signature: Date: d3 �7�� 7 <br /> Building OffiaaU Inspector. Date: <br /> F�e2 <br />