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EI -4't_:z:.3Wn,-'-ti:'it::;;:2:::l:at7-Z2iirf ;::T: i,TiIFi.-;4ieF,AIAF10-ZtfillSllt <br /> FIXTURE BSMT 18T 2m:I OTHER FIXTURE I BSMT 1 I 246— OTHER <br /> TYPE Floor Floor <br /> TYPE Floor Floor <br /> Water Closet Floor Drains <br /> Lavatory 3 Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Silicocks Miscellaneous <br /> 1. CONTRACT PRICE * is 1.25%of contract price with a (Minimum Fee of$50.00) <br /> S A50 x ..0125 $ 9o.6,3 <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> 5..0 x .0005 $ 33 <br /> (contract price) <br /> 3. POSTAGE & HANDLING (Only on Mail-In Applications) 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) •,2(e <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 /> • <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 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: 0.114.- tcti.k.€ Date: ir9 la-18 <br /> Building Official/Inspector: Date: <br /> 73-14 t 3 - I g <br /> auk- Ca,it -Pas( VA-4c4- - 2 <br />