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01/31/2014 FRI 12: 53 FAX 763 473 8565 Sabre Plumbing & Heating �004/007 <br /> If above does not apply;foliow guidelines below: <br /> 1. (`ONTRACI'YI2ICL * is 1.25%of contract price with a(Minimum ree of$50.00) <br /> �Qa�o.o� X a�25$ Z3�. 3g _ <br /> (contrscLpricc) (mininzum 550.00) <br /> 2. S'I'ATE SURCHARGE (� �y � ���� <br /> ._�I"i d�I O UO x.0005 $--- ._ �-J 7.._._----- <br /> (c;ontmct pnce) <br /> 3. Pt�STAG�,&HAi�DLII�IG(Only on Mail-In Applications) $ �-bfl` <br /> 4. TOTAL PF.RMI'I'rE�(Add Lines 1-3 Above) $ Zf--�� .� � <br /> • "` CONTRACT PRTCI? or JOI� COST means d�e actual or esiimated dollar amount charged for U�e <br /> permitted work inciudin�materials, labor,profit,and other fixed costs. lt is the amount to be charged <br /> to t31e customer for the work done. If any material, equipment, lahor or installations are furnished by <br /> the owner, tenant or any other��arty, the reasonable market value of such items must be added to the <br /> estimated cost or contract price for pennit fee purpases. ln the event diat there is a dispute on the <br /> amount of tl�e job cost, tlie City may request the submission of a signed copy of the actuat contract. <br /> 7'he unde�signed hereby applies to tl�e City for issuance of a Plwnbing Permit, agrees to do all <br /> work in stnct accordance with the ordinances of the City and the re�ulations of the State of <br /> Minnesot��, a�id certifies that all statements made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: (,�(,f� ��(,�,�,�}-�(,�hJ Date� _ 1 ,� � �D�� <br /> i ,i��( ,'���,;`�� <br /> r I <br /> 3 <br /> I <br />