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. , <br /> FfXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1sr 2ND OTHER <br /> TYPE Floar Floor IYPE Floor Floor <br /> Water Cioset Floor Drains 9 <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 /> . , <br /> 1. CONTRACT PRlCE '` is 1.25%0#corrtract price with a (Minimum Fee of$50.00) <br /> - � X .Q,2� � $ 5�: o � <br /> (��a� p�) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> � X .0�5 � l� �� � <br /> - (contract price) <br /> 3. POSTAGE&HANDLING (4nly on Maii-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Abo�e) $ 5J�`�� <br /> " CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor, profit, and o#her fixed costs. It is the amount to be charged to <br /> the customer for the work done. If any material, equipmerrt, labor ar installations are fumished"by the <br /> owner, tenant or any other party, the reasonable market value of such items must be added to the <br /> estima#ed 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 /> , <br /> , <br /> The undersigned hereby applies to the City €or issuance of a Plumbing Permit; agrees to do all work in <br /> • strict accordance with the ordinances of the Cityr and the regulations of the State of Minnesota, and <br /> certifies that aH statemerrts� e on�this appfication,are com�fete, tru�nd correct. <br /> Applieant's Signature: Date: � c� <br /> Buiiding Official/ lnspe�tor: Date: <br /> �2 � <br />