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12/31/ 012 MON 10: 3� FAX 763 473 8565 Sabre Plumbing 6 Heating �f007/007 <br /> ' ' I <br /> c�"- �� , . �',�.��,�,�!�".��' �.�����..�.�'������ <br /> ` •��.�f�:�,p�''��'.������`.�'��.''.��1�.�'�:�+` - � ,.� <br /> � ❑ I'es,tl�is sectio,i applics <br /> 71�e replaccment of a R�i�ential fixtuE•e or,�p(iance that meets all three of the following requirements: <br /> 'i <br /> 1. Does not�require modification tQ electrical or�;as service. <br /> i2. Has a to 1 cost of$500.00 0�-less;excludi7lQ the cost of the fixture or appliance: and <br /> 3. Ts improved, installed or rep�aced by the hoineowiier or lic:ensed contractor. <br /> ` Skip next section, iC this applies; Cost of Permit $ 15.00 <br /> � Siate Surcharge � 5.00 <br /> j Mail-In Feo(If Applicable) 5+ 2.00 <br /> � Total Pcrmil:I�ee $ <br /> i: <br /> �- il r��' <br /> ' �% ^'.- lf abav��;oes'ii'oY aaj�fy; !'ollow gu'idelines 1��elow:` - _ - n; •^ ,., <br /> S�. C:(J�1V'TI2AC:7t'PRIC�, "` is ].2S%of.contract price with a.(IVlinimum Fec of$50.00) <br /> x .07.25 � ' <br /> ' ___ � :i`� `. (' 'C. _.___._.. � _ �' .—_ <br /> � (conlmcl pricc) (tnic�imum$SO.W)� <br /> 2. S�1 AT�SLJRCHAR�E r, � <br /> �� , i �_.. <br /> ' -i_..:�,._' ..i.: '�_�_x 0005 � �---,-_ <br /> ---- (cont�act p�icc) -.__._....- --- .. .. <br /> 3. POS1'AGE&H.ANDLING(Only on Mail-In A.pplications) $ 2 00 ______„_ <br /> 4. TOTA1�P�RMl'1'FEE(Add Lines 1-3 Above) � � �'1�' <<-' <br /> ° * CONT'RACT' PR10E or JOB COST means the actual or estimated dollar amowit charged for the <br /> permitted work including materials, la�or, profit, and other fixed costs. lt is the amount to be chargod <br /> i:o the cust��per for t1�e work done, It�a.ny material, eqvipment, laUor or ii�stallations are fi�rnished Uy <br /> the owner, tenant or any otl�er pariy, She reasonnb).e market value of such items must be addec3 to the <br /> estunated cost or condact price for Y� rmit fee purposes. In the evei�t that chere is a dispute on the <br /> an�ouuc of t]�e_job cost, the Ciry rnay request fhe Submission oP a signed cop,y of the actuai contract. <br /> Tl�ie undex�sibned hercby applies to tlie �'ity Por issuance of a Mech3rtical Aermit, a�ees to do ali <br /> ��vork in strict accordance with the or�iinances of the City and t}�e re�ulations of lhe State oi' <br /> Minnesota, and cerCifies that all state ents made on this applicatxon are complete, true and <br /> correct. <br /> �i <br /> Applicant's Signature �.i:t.Ll.,i i..���.1:i,(,f • �;�,�;L'�- Date: (.1. .';( !1.....T_ <br /> '` '�Y� I ��,' �" �`. <br /> ,p� <br /> � <br />