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O1/31/2017 TUE 8: 59 FAX 763 473 8565 Snbre Hedting 6 Air Cond �007/007 <br /> I�sbave doos nat apply;follow guidelines below. <br /> 1. �OAITAACT PAICL " ia 1.Z5°�of contract price with a(Minimum Fee of 550.00) <br /> --��� �3�o�„ x.Oa x5$�'�__,,.,,,� <br /> (oontract prieo) (miolmnm 5�0� <br /> 2. �TATE CURCHAB�F. <br /> ��, 1.3le.oQ x.000s $ 1 I•S�'i <br /> c���t p�� , <br /> 3. POSTAGL&HAIVDLTNG(Only on IVlail-In Applications) $ 2.00 <br /> 4. TO'TAL PFRMI?FF,�(Add Lineq 1-3 Above) S�Q�.^�_'� <br /> • ' CON'TRAGT pRICE or JOA COST mes�s the sotual or eatimated doltsr amount chsrged For tl�e <br /> permittecl work inaluding materials,labor,profit,and other�xed costs. It is the amount to be charged <br /> to the ousoomer for the work done. If any materiel,equipment,laba•or inetallstions are fianiahed by <br /> the owner, unant ar any other party, d�a reasonabie market value of euch itc�ns must ba added to the <br /> esamatsd coat or contract price for permit fee purposes. [n the event that there is a diapute on tha <br /> amoum of the job cost,the City rnay requast the submi�sion of a signed copy of the actuat comract, <br /> 'Tlae undersignsd hereby app�ies w the City for issuanob of a Ptumbing Pex�nit� agroas ta do all <br /> work in atrict eccordance with the ordinences of the City and the reguletiona of the 3tate of <br /> Minnesota, and certi�ea that all statementa made on this application aze complete, true and <br /> correcti, <br /> Applicant's Signature; ��p ��,� Date; �• �]•Zp/� <br /> . � � <br /> 3 <br />