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10/06/2014 MON 13: 56 PAX 763 473 8565 Sabre Heating & Air Cond �J004/004 <br /> Yes,this section applies <br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements: <br /> 1. Does not require modification to electrical or ps service. <br /> 2. Has a total cost of$50000 or 1m;excluding the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor. <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> State Surcharge $ 5.00 <br /> Mail-In Bee Of Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee or moo) <br /> --1"1•Z1•( o _ x.0125$ L-51 <br /> (contract pnco) (minlmuPS$saoo) <br /> 2. STATE gtrltt"ue►nr_r+; <br /> (=Mot pries) — <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ ._ __ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S 102---6:7 <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 <br /> to the customer for the work done, If any material, equipment,labor or installations are furnished by <br /> the 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 /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: 6 Date: <br /> II <br /> 3 <br />