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� � . <br /> . . <br /> , ,� ,;,� - - �� n,:PLC111A$�1�����i;�'�1�����ilti[�.�1�+���"����`��`��`��;����� �;� ��.� � ����� <br /> • FIXTURE BSMT �sr 2ND OTHER FIXTURE BSMT 1ST No <br /> NPE Floor Floor 2 OTHER <br /> NPE 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 /> � <br /> "�:€� a� s.3������/,'�����w������ X ���3 -��+� ��3�3�' ;;;j, �S� <br /> ., s . . .r,� . <br /> . . , , <br /> , « x <br /> . ,�s._ . ,,�- .�, ' <br /> S`c .e,s -�vd �.9 .. Y 6 <br /> - ,-'� -. •�'-„ i, <br /> 1. CONTRACT PRICE " is 1.25% of contra�t price with a (Minimum Fee of$50.00) <br /> ---._ � x .0125 $ � 1, �}� <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) $ ��. L'� ��j <br /> * CONTRACT PRtCE or JOB COST means the actual or estimated dollar amount charged for the <br /> permitted work including materials, labor, profit, and other flxed costs. It is the amount to be charged to <br /> the customer for the work done. If any material, equipment, labor or installations are fumished 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 /> PI:L�M�3�I�iG�P�€�it��/k�:�?��AfiIt�I��+iG�E���';�=� j� � � �< , �,_�- <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 af the City and the regulations of the State of Minnesota, and <br /> certifies that all statements made on this appli tion are complete, true and correct. <br /> ' � <br /> ApplicanYs Signature: Date: U <br /> Building OfficiaV Inspector: Date: . <br /> Page 2 <br />