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09/24/2010 FRI 14: 20 FAX 763 473 8565 Sabre Plumbinq & Heatinq �J003/003
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<br /> � Yes,lhis section applies
<br /> The replacement of a Residentiai i'ixiw•e or apnliancc that meets all three of tl�e following requirements:
<br /> 1, Does not require modification to electricnl or gas service.
<br /> 2, l�as a total cost of$500.00 or less;exc u i die cost of the fixture or appliance:and
<br /> 3. ls impraved, insfalled or replaced by the honi.eowner or licensed contractor.
<br /> Skip next section, if this appiies; Cost of Permit � 15.OQ
<br /> �StateSurchArge S.._ 5•QO
<br /> A�(ail-ln Fee(rf Applicable) � 2.00
<br /> lbtal Permit Fce $
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<br /> If above does not�pply; fallow�uidelines b�low:
<br /> !. CONTRACT 1'RIGC " is 1,25%of conu�act��rice�+�ith a(�4inimum rcc of�50.00)
<br /> 15,455 . .o�2s � 193.19
<br /> (conlract price) (ntinim�nn$50.00) ..�..��..
<br /> 2, S7'ATE SURCHARGC ** Add the State Bldg Code Div. Surcharge(1linimum l�ec afSi.00)
<br /> 15,455.00 X.oaos �7•73
<br /> (contract pricc) � (minimwn b 5.00)
<br /> 3. POSTAGE 8 I-iANDLING(Only on Mail-�n Applications)' $ 2.00
<br /> , 202.92
<br /> 4. 'T07'AL PF.RMI'f F�E(Add Lines I-3 Above) , $
<br /> � * COI�TRACT PRICC or J013 GOS'T means th�;actual ar estiniatecl dollar amoturi charged for the
<br /> ��e��nitted work including materials, labor,profit,an'd ather fixe�!'costs. It is the amount to be charged
<br /> to tl�e customer for the woi•k done. lf an�� material, e�uipinent, labor ar installations xre furnished by
<br /> the<�wner, ten�n� o����,y otne�• p���ry, �he reasonaUle market value of si�ch itcros musl be added to thc
<br /> estimated cost ar con�racl price f'or pern�it fee purposes. ln�the event that lhere is a dispule on Ihe
<br /> amount of the job cost, tbc Gity may request the submissioii of a sianed copy of the actual contract.
<br /> ■ *'�'1'lie S1'A'TL`SURCI-TARGL is.00QS times the ConU•act 1'rice or a minimum of a5A0.
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<br /> The undersigned l�ereby applies to thc City for issu�nce of a Mechanical Permit, a�;rees to do all
<br /> wark in ssrict accordance with the ordinances o!' the City and the re�ulations of' the State of
<br /> Minnesota, and certifes that all statemcnts made an ihi� application are complete, truc and
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<br /> Applieant's Signature�-' �;�ate; G �- .___mm_
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