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04/08/2013 MON 7: 53 FAX 763 473 8565 Sabre Plumbing & Heating 0007/007 <br /> ■ <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 gas service. <br /> 2. Has a total co of$500.00 or less;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 Fee 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 of$50.00) <br /> ut x.0125$----- <br /> iC. <br /> (Contmet price) (minimum 850.00) <br /> 2. STATE SURCHARGE <br /> •r. <br /> ._.2 a., _X.0005 $__._.__ ___. _.•' <br /> (contract phee) <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2,00_ <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <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: <br /> Pp ' B Date: <br /> 3 <br />