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03/15/2017 wEo 7: 51 FAx 763 a73 8565 Sabre Heating � Air Cond �004/OOa <br /> � Xes,this section Rpplies <br /> T1�e replaceu�ent of a Bssi�suttiai f'rxture or a�plianc�that meets all three oP the foliorwing requirements� <br /> 1. Does not require modi�carion to electrical or ges secvice. <br /> 2, k�Ias a m�l��of$500.00 or less;�jag the cost of the fixture or appl iance:and <br /> 3, Ts improved,instaJled or replaced by the homeowner or licensad contractor. <br /> ------._..__ u _._._.; , . .,pp: .' , ., . ._.._..... . ..:.. .._. .--�--:�-.-�- ---� <br /> Ski next secEion if this s l�es� Cost of Penmt � � �____1?.OQ � ` <br /> State Surchargo $ , S•00 <br /> Mail-Yn�ee(If App!icable) $ 2.00 <br /> Totnl Pe��mit�cc $ <br /> I if above does not apply;follow guidelines below: <br /> 1. CONTRACT PRICE w is 1.25%o��ntract prica with a(Minimum Fe.e of�50,00) <br /> ����,Q�O x.012S� �'1��� ��'1 <br /> (contrflMprice) (minimum 650.00) <br /> 2. �xE_S[iXtCI�AltC� <br /> 33�35.QO x.000s s..��__�T.._ <br /> c«��r�) — <br /> � 3. POSTA rC73&HANDT.ING(Only on Mail-In Applica#ons) � 2.D0-.---.-. . <br /> , 4. TOTAL PER11�T�'�(Add Lincs 1-3 Abo�ve) $ ��1-q�D <br /> � <br /> ! ■ 4 CONTRACT P`�tICF or JOk� COST means die ac�u$1 or estimated dollar aanount cbarged for the <br /> I � pumitted work including materiats,tabor,pr�t,nnd other fixed costs. lt is t3�a amount w be aharged <br /> I to the customer for the work done. If any material,equipment, labor ar installations aro fiunished by <br /> ' the owner, te���t or arry oA�er party,die reasonable markat vsluo of such it�ms must be added to the <br /> i estYmated cost or contract pricc far parmit fea purposes, In the e�veut that there is a diapute on the <br /> ; amaurt of tho job c�st, tha Gtiy may request ihe submission oP a signed copy of the actual camtract. <br /> i <br /> � � <br /> � <br /> � The undersignod herebry applios to the City for issuance of a Mecha�ucal Pennii, agrees to do el] <br /> ' work i�n strict accordance witli the ordinances o£th,e Ci�ty and the regulatiozas of tha Stata of <br /> � Minr�osota. a�ad caztifies that alI statozz�ozats mado on thia applicatioa sre completa� true and <br /> � correct. <br /> i <br /> i Applicant's Signature: �,�j�(iv�/ Date: �'��'Z.0/'y <br /> � <br /> � � . <br /> � <br /> � � <br /> 3 <br /> i ' <br />