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• r <br /> FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER <br /> TYPE Floor Floor TYPE Floor Floor <br /> • <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 /> Sil'cocks Miscellaneous I <br /> 1. CONTRACT PRICE * is 1.25% of contract price with a(Minimum Fee of$50.004 <br /> x .0125 $ <br /> 5-76 <br /> (contract price) (minimum $50.00) <br /> 2. STATE SURCHARGE 2 <br /> (POD x .0005 $ - 3 0 <br /> (contract price) <br /> 3. PO TAGE& HANDLING (Only on Mail-In Applications) $ 2.00 <br /> s -A 3u <br /> 4. TOJFAL PERMIT FEE (Add Lines 1-3 Above) $ <br /> * CONTRAC PRICE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted wo 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, tenan or any other party, the reasonable market value of such items must be added to the <br /> estimated co t or contract price for permit fee purposes. In the event that there is a dispute on the <br /> amount of t job cost, the City may request the submission of a signed copy of the actual contract. <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in <br /> strict accordance with thordinances of the City and the regulations of the State of Minnesota, and <br /> certifies that II stateme . made on this application are -•mplete, true and correct. <br /> I `-, <br /> Date: 3/09ma /i <br /> Applicant's S nature: Aa . . 1�� _ <br /> r <br /> Building Offi al/Ins.= or:. <br /> Date: <br /> Page 2 <br />