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03/27/2018 12:20 FAX 9529335049 CULLIGAN MNTKA 2003 <br /> - kt. <br /> .;:rPLUiVIBING.1.EIX l RES„BEO,NG NSTP►L QED <br /> ' 4s <br /> ' FIXTURE BSMT 1sT 2ND OTHER FIXTURE BSMT 1ST 2N0 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 I <br /> Dishwasher Wet Bar <br /> Silicocks Miscellaneous <br /> (...j.-.y.._aoq„K:,:.:. .::. �::�:. ^_�,'i i:,:.;d':::qk.;. ... .. � .. �.t `:ti ;'4_Fa. n�ya:.:::::y;D��:�:y�i,.;u.a::.6:�.;,:.r;,'h.l'..�..:,�_:...��h.._: ti� S"; <br /> cl....... ..,4i5.t... . ....•�.,.;T.�::L II�gN,A- 5.'•_.• l_._:;. .'�,. ':.: _:"Y - ::5...,.+..+.1.:d•..-:. '--;w�, .:PL <br /> [„tl�,a.��bSe.�: r.d.�„4!4�� Y`_v:r -+:+fri: - k.]:'� � 'y ,., r. �..�T.-�t' ... .__.__... .... :$�:�,',k�f[b P' a':�=-:,�.e�'p"b.`-�f'�. ',�"`,`�'.: �� �P.�V. <br /> 1.- CONTRACT PRICE *is 1.25% of contract price with a (Minimum Fee of-$50.00) <br /> c 94 '3. 00 x .0125 $ SD. 00 <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE <br /> x .0005 $ J. 9 <br /> (contract price) <br /> 3. POSTAGE & HANDLING (Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ 3a. 971 <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 cbntract'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: 4 2±71 Date: 3- d`? - I D C/ <br /> Building Official/ Inspector: Date: <br /> Page 2 <br />