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Mia r. 22. 2018 4: 00PM No. 0892 P. 3 <br /> FIXTURE BSMT 18T 2N0 OTHER FIXTURE BSMT 18T - ~' 2ND OTHER <br /> TYPE Floor Floor TYPE Floor Floor <br /> YWater Closet _ C I I Floor Drains 1 <br /> Lavatory Sewer Ejector <br /> Bathtub I ` Laundry Tray <br /> Shower Washer <br /> Kitchen Sink 1 Water Heater 1 <br /> Disposal 1 Water Softener <br /> Dishwasher J Wet Bar <br /> Sillcocks Miscellaneous <br /> 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> 11, 006 x.0125 $ 131 5° <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> 111)00 x.0005 $ 5. 5° <br /> (contract price) <br /> 3. POSTAGE &HANDLING (Only on Mail-In Applications) $ 2"00 <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ / C/6, " <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, y <br /> the g7pp City may request the submission of a signed copy of the actual contract. <br /> ,..-:12',..- 1."."vt• 1,-r.a 9L 4I. :�,,!eco � i1. i, <br /> I� 'YI',r'I[.4�',rn4.Ii11106(R.Z``�'i}; <br /> • "1'd.=i,5"TY." - k ti .. . .:'1 <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 made7n this application are complete, true and correct. <br /> 0 <br /> Applicant's Signature: « Date: 3-,70-/ K <br /> Building Official/Inspector: Date: <br /> Page 2 <br />