Laserfiche WebLink
U'. <br /> FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER <br /> TYPE Floor Floor TYPE Floor Floor <br /> Water Closet 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 /> 4 <br /> PRfl7E CtAL tLATfp(�'° <br /> 1. CONTRACT PRICE is 1:25016 of contract price with a(Minimum Fee of$60-00) <br /> ,onQ .00 x.0125 $ V.5() <br /> (contract price) (minimum$50.00) <br /> 2. STATE SURCHARGE <br /> � <br /> m(J.oo x.00QS $ D 0 <br /> (contract price) <br /> 3. POSTAGE&HANDLING (Only on Mail-in Applications) $ 2.00 <br /> 4. TOTAL PERMIT PEE(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 assigned copy of the actual contract. <br /> V-1 L� <br /> h3 4 4 ` a 51 T 'I��VW�I ''!'• Ti�3 <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: Date: t 1 <br /> Building Official/Inspector. Date: <br /> Page 2 <br />