|
03/27/2018 12:22 FAX 9529335049 CULLIGAN MNTKA lj007
<br /> f PA.UM81 G_....ITOR S- E N :S7A..,_LE,D4::r
<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 f
<br /> Dishwasher Wet Bar
<br /> Sillcocks Miscellaneous
<br /> xr�-i�.M- z..,..,....w -.... �a;a-. .__.s.6,..,t.4 a-•x.„nn.,i:r.: a:•.:ts:sixa:' .c. - i.ssnn;...:v l:i :w.,rv!ro::.
<br /> �? :. z:a.�:�..r.-?i,-e .�i,r?.:,.li,,:,,a'�^.:��i..::.....;.,T.l: - �y:� ...S:i�::fi:r ., w'%i �=�.. ,i$!:�+�''::.,, a.-s=`�:n
<br /> -
<br /> . .,x?•- .v,!,. '�+. � � 1..,,,.-!... .. .......... ..� yT,,...:T .: � �- �:Ci..a.v. x: :`r_.. - w��'k.
<br /> _:.. ,...:,._. .,✓. .... >.,.. _. „.... ..........:..�5.....,.......„„ _�R'��rT..��M� �,.�°tr ' ....�� 1;5 ::s'�. i�ai„P:,-:s::1;r..,t, .� .!�:_.;. _� ."�:.;>':�Fr.
<br /> 1-.- CONTRACT PRICE *is 1.25% of contract price with a (Minimum Fee-of$50:00) -
<br /> oQo� . Qu x .0125 $ 550. 00
<br /> (contract price) (minimum $50.00)
<br /> 2. STATE SURCHARGE
<br /> x .0005 $
<br /> (contract price)
<br /> 3. POSTAGE& HANDLING (Only on Mail-In Applications) $ 2.00
<br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ sa• as
<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 /> .... �-'- - .. µ �x `., c i ..; •::.:;,i. ... .-.• ".^.:�r:` .i4�:e;";. ''c''.�itF.'-��.u.`t54;�q
<br /> Y �;x:�:� '�_ . -•:.: ,;r. ....:.. .. ..: `� _ - _ -.ass:},..y:.,. aN�,;w�r!:. �, ."�,,;`..
<br /> ,. .. .::,, , ,.._ ..:.. .:P,.��f�QI:�I�.�E?;C�fj �P� 7`J�3�l��kRt� E�I �:��..E:�,.��.. :;. �� _• �.
<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: L.S7 ecir Date: 3 - 017 - IS
<br /> Building Official/Inspector: Date:
<br /> Page 2
<br />
|