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. i,"- � � � '., q� J ` ��� <br /> ' -_' 3 �. �_� ^ .� � <br /> . .. .. ... � � <br /> �: -� ' e .. .'P . - '�.:i...�, � <br /> FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1sT 2ND OTHER <br /> TYPE Floor Floor TYPE Floor Floor <br /> Water Closet Z Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower � Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> . w�� . <br /> _ ,� � ° , a� <br /> , � � , , �� � � : �� � <br /> , � , �� �� . n � . �A w,s <br /> 1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> �� , sn,ti x .0125 $ <br /> (cont act price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> x .0005 $ <br /> (contract price) <br /> 3. POSTAGE � HANDLING (Only on Mail-In Applications) $ 2.00 <br /> ���-� � <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 /> ��;�: - - � m :.. . ..,., . ...... . . `� ,' '.�.�4+�������. y i_�j� ����A��... ���u�'�r�N�"���•: „td€�+�'���^+�'�. <br /> �- _ . �_ - � s -� ., . ._ :. .. <br /> The undersigned hereby applies to the Cit issuance of a Plumbing Permit, agrees to do all work in <br /> strict accordance with the ordina ces of e C y and the regulations of the State of Minnesota, and <br /> certifies that all statemen e this ap li ti n are complete, true and correct. <br /> Applicant's Signature: Date: ` �'' 7� �(� <br /> Building Official/ Inspector: Date: <br /> Page 2 <br />