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05/10%2013 FRI 10: 32 FAx 763 473 8565 Sabre Plumbinq & Heating �J007/007 <br /> , <br /> > <br /> ���.�';���;���������� ; <br /> #A����3.��� �t�p��T�1TE SZ"1�'�'t�E :' . .. . <br /> ❑ Y�s,this sec�ian applies <br /> The replacement of a 32esiciential fixture or anpliance that meets ail three nf the fc,llowing requirements <br /> t. Uoes not require modifiairicm to elecu•ic�31 or gas sc:n�ice. <br /> �. 1•it�s a lotal u>st of�SOO.UO or less;excludina the cost of the.fixture or appliance:and <br /> :i Es imprc>ved, insialled or replaced by the homeawner c�r licensed c<�n�racror. <br /> Skip next seccion,iPthis applies; Cost of Aermit � 15.00 <br /> S�ate 5w�charf;e �__.__ SAU <br /> '�1xil-ln Fee(lf Applicable) $ 2.00 <br /> 'Total Permit Fee � <br /> ���`���:�.�.��.�.`��:��� ;�-.���;Q���i��3�.0 <br /> lf above does not apply;folfo���guidelines belo��•: <br /> 1. �'ONTRAC;7'PR1C�: * is 1.2>�•0 0l'contract}�rice with a(l�1inimum Fee of$SU.00) <br /> �'� li ,l • _,�� <br /> ���.�.�!� ..— x.01?5 S......_._�..�'il�.'...J...`�--............._.. <br /> (conb'act pricci (minimum SSU.IH►) <br /> 2. STATE SURCHARGE , . <br /> (�' ��•�l ` +:.Ocw� $ �•��.�7 <br /> _.._.._........____�..._�......_..__�_................... --._...._._------............................_ <br /> ���>�,�r,��,i,�,«� <br /> 3. 1'057'ACiE&:HANDLING(Only on A9ail-ln Applications} � ..?-�1 <br /> a. T07'AL PERMI'T FEE(Adrl Lines 1-3 Abavc) � )��! �� <br /> • * CUNTRACT 1'RICE or JOB COST means the actual or estimated dollar amount charged f'or the <br /> nerrnitted work includins�materials, labor;protit,and other fued costs If is the amount to be charged <br /> to the custom�r for the���ork done. If any m�terial,equipment, labor or installations are Purnished by <br /> the owner, tenant or any othc;r party, the reasonable market value of such items must be sdded co thr. <br /> estimated cost or contract }�rice f'or pennit fee purposes. in the event that there is a dispute on the <br /> amount of the joU co�t, the C'iiy may request the submission of� si�ned cop,y of the actual contract. <br /> : <br /> �v1E�kCAN��.�FERM��'A�1'�.��C�►'�'��Ql�A,�R�E��1`T <br /> 't'he undersi�ned hei�eby� applies ro the City for issuance of a Mechanical Per,nit, agre�s to dc� all <br /> ���ork in strict accordance with the ordinances of the City and the re�;ulatioi�s oi' the Siate o}' <br /> ?�linnesata, and certii'ies that all statements 111<1CIC cm chis application are cornplete, true aiid <br /> C017'CCl. <br /> e <br /> � , ' : <br /> _ . <br /> Applicant's Si�nattu�e: ::: . .�. ��.J_u%�-'4_�_�._��,Li,•�;'_�.�;�k.___ �ate: . �.�...:�� �G�_'� <br /> RB��t"�QI�!'1 <br /> , <br /> , <br />