Laserfiche WebLink
O1/24/2017 11:43 FAX 9529335049 CULLIGAN MNTKA C�003 <br /> � . ,: <br /> �s . ,. _; . �; � :'.PLUMBING FI?CTURES BEkNG lNSTALLED .. . :.. .- <br /> FIXTURE BSMT 1sT 2ND OTHER FITMPEE BSMT Fioor Floor OTHER <br /> NpE Floor Floor <br /> Water Closet Floor Drains <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Hea#er <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks MiscelEaneous <br /> ;���°,,.,�a,= . . . .::��� . .�.�;�'. ._��4 .�w �, ,P��MIT:FEE.C�4��U:tATI�N, , ° � � ,�'�, <br /> ,s� � � �- <br /> 1. CONTRAC'F PR10E * is 1.25% of contract price with a (Minimurn Fee of$50.00) �,�, <br /> . �����/ � x .0125 $ ��> �, <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE �� �� <br /> ,J, r- <br /> x .0005 $ <br /> (contract price) <br /> 3. A�STAGE 8� HANDLING (Only on Mail-ln Applications) $ 2.b0 <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) � <br /> ����_;> > `}�� <br /> * CONTRACT PRICE or JOB COST means the actual or estimated dollar amoun# 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. ln the event that there is a dispute on the <br /> amount of #he job cost, the City may request the submission of a signed copy of the actual contract. <br /> �; +;'� � r�' �'` P,:L.UMBI'NG.E'� RMITN1APPLICAT�0�1�1 AGf���E11�lENT' �_�,�� : ;`�. _ <br /> , �� � � � � , <br /> , . .,. . <br /> ,, ; <br /> The undersigned hereby appfies 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 are complete, true and correct. <br /> Applicant's Signature: <br /> D ate: 1 �y ' 1 � <br /> Building Officia{/lnspector. Date: <br /> Page 2 <br />