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� . <br /> , � �� �= a�� <br /> .� � . ._ . x <br /> � :�'. <br /> FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1sT 2ND QTHER <br /> NpE Floor Floor TYPE Floor Floor <br /> Water Closet � f 3 Floor Drains ( <br /> Lavatory � � L� Sewer Ejector <br /> Bathtub Laundry Tray � <br /> Shower � 2 Washer � <br /> Kitchen Sink � Water Heater 1 <br /> Disposal 1 Water Softener � <br /> Dishwasher l ! Wet Bar �� � <br /> Sillcocks � Miscellaneous <br /> 1. CONTRACT PRICE " is 1.25% of contract price with a (Minimum Fee of$50.00) <br /> /4, S bD � x .0125 $ Z�� • 2 S� <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> /4, sbo � _X .0005 � $ , Z.� <br /> (contract price) <br /> 3. POSTAGE 8� HANDLING (Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) � .2�`r • �� <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 /> _ ._.. ._ , u � F ,w <br /> . . <br /> . � � � . , � _� <br /> . ,. <br /> .. <br /> , � �r '. o .. a.. � • .r <br /> . . <br /> r. � v i <br /> F. .- . �, ' � _ <br /> . �:,. .w z ». .. �> .. _ ._ , . <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 ity and the regulations of the State of Minnesota, and <br /> certifies that all statements e this ap ation are complete, true and correct. <br /> Applicant's Signature� Date: �� I r `� <br /> Building Official/ Inspector: Date: <br /> Page 2 <br />