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08�09/2R�2 THU 15: 11 FAX i63 673 8565 Sabre Plumbinq i Heating �J007/007 <br /> ,.. . '.:::`.:::' ,':°`,.. ';..,': ::: �;"::'::::;::P�RiYII'T:�FEE,:CAI;CULATION(S).::'�:::.�°:`:`;:..:::`:`;: :::;;.:.:.::::: ::`...::. <br /> ... ....... . ... ....... ... : .... <br /> : .::.::::::: ::..::::BASED.ORR�'2002 ST.�J.TE STATUE `.;;:`:°...`;:`:;:':.::'::.. ; ;°,;: ::.:`:::.: ,:.. <br /> ❑ Yes,this section applies <br /> The replacement of a Residential fixture or ay�pliance that meets all three of thc foilowing roquirements: <br /> 1. oe no require modification to elecfical or gas service. <br /> 2. Has a Rotal cosi of$500.00 or less;excludin¢the cost of the fixh�re or applianc�:and <br /> 3. fs improved,installed or replaced by the homeawner or liccnscd contractor. <br /> Skip next section,if this applies; Cost of Pormlt $ lS.OQ <br /> State Surchnrge $ 5 0 <br /> Mail-ln ree(if Applicable) $ 2.00 <br /> Total Permit Fee S <br /> . . . . .......... <br /> ; ;' ` PER1v1IT FEE'CA'L:CtJI:;ATIOl�T S ,-�JOBS OVER$500:�0 ` '` ; '`: ` � , <br /> If above does not apply;follow guidelines below: � <br /> 1. CC,�NTRAC�'I'�RICE *is 125%of contract price with a(Minimua�Fee oP�r50.00) <br /> ���j�.n,�� x.O l 25$, �„�,7.•�'r�,,,,�' <br /> (contmct pricc) (miuimam SS0.00) <br /> 2. 5�;,�},TE.S[1RCHARGE <br /> ,13X4�0o x.000s � �.lo� <br /> (comra�.K pricc) <br /> 3. AOSTACE&NANDLING(Only on Mail-In Applications) $ 2.00 ^ <br /> 4. TOTAL PERMIT FEE(Add L.ines 1-3 Above) $ a5.a�I <br /> • * CONTRACT PR]CE or JOB COST means the actual or estimated dollar amount chargad for the <br /> pem�ittod work including materials,labor,profit,and other fixed costs. lt is the arnount to be charged <br /> to the customer for the work done. If any material, equipment, labor or instnllations are fumished by <br /> the owner,tenant or any other party,the reasonablo mArket value of such iteans must be added to the <br /> es[imated cost or con(ract price for permit fee purposes. In the event that thare is a dispuYe on the <br /> amaunt of the job cost, the Eity may requcst the submissinn of a signed copy of the actual contract. <br /> MECHANICAT��PERMIT A1�PLICHTION AQREEMENT` ` ` <br /> The undcesigned hereby applies to the City for issuartce of a Mechanical Permit, agrees to d� all <br /> work in strict accordance with the ordinances of the City and. the regulations af the State af <br /> Minnesota, and certifies that all statements made pR this apptication are complete, true and <br /> correct. <br /> Applicant's Signature: ���>�� ,�,(�d��(,1� Date: 0"�/'ZO/Z. <br /> Reset.F.o�n: <br /> 3 <br />