|
11/22/2011 TUE 9: 38 FAX 763 473 8565 Sabre Plumbing & Heating 10004/004
<br /> 2'�un> .h, 7 d ?"�"y+'�',G',I c`tr ri G a u } �n'O - `'i. a,: s cs� i? t 4 da, 4�.x t.:•
<br /> �Y"J 5 , ,- , C�, 6}EC E,,EI':rE1F['C 41 ,A n�5 e y
<br /> `�-b1t5`w:rr'cv�i.�t�k� `r n 40,,;,,,,,,,"....;,--,,,,,_,,,-,,,..„,,,,w ��� � �;;y�rJ 4 � h.--.t 1. U � ��r? �, m a,�`�J F`'�'�J 7u� F�.k�.ky �`t
<br /> a i '"� 1- t3 Uri " 9 t Q a a�1`UN2` r�? 1L° �`'�i> 1:.T?rc� ,,,,, ar ,
<br /> ,.s�w. ��`",, ,�y!t�i .� ,�... �,���. ,.>:`4��3 ��!1,���.�5/����:shd. ri:.L4.�s�.'�.r�rw��'�;..nCS`�y.'�
<br /> ❑ Yes,this section applies
<br /> The replacement of a Residential fixture or appliance that meets all three of the following requirements:
<br /> I. Does not require modification to electrical or gas service.
<br /> 2. Has a total cost of$500.00 or less;excluding the cost of the fixture or appliance:and
<br /> 3. Is improved,installed or replaced by the homeowner or licensed contractor.
<br /> Skip next section,if this applies; Cost of Permit $ 15.00
<br /> State Surcharge $ 5.00
<br /> Mail-in Fee(If Applicable) $ 2.00
<br /> Total Permit Fee $
<br /> r,,,, �° s7' S 1"3,c cs.'�`� �{v§^r, f� d 3`" "u,,r't 3.v�-�[l (}�y�"Y 1< �< Y.� ��!+�5; 1 m��g.-}a�'kti�r.2- m^r � a 4
<br /> +,w.._,;7,,,�3' ,e(.'�.,i t� 5 k;`_�5s ;P• S;.` M),' `y -' '^E`'F .M;2c'. .ka`f'�.."e'xD..A1.4F`.` J:k. •
<br /> if above does not apply;follow guidelines below:
<br /> I. CONTRACT PRiCE * is 1.25%of contract price with a(Minimum Fee of$50.00)
<br /> -'?)(31 0`:55,6"9 x.0125$ Li • i 01
<br /> (contract price) (ninimutn$50,00)
<br /> 2. STATE SURCHARGE +(�
<br /> () 1t,)--- ;7 �1i x.0005 $ {"I if)1)
<br /> (contract price)
<br /> 3. POSTAGE&HANDLING(Only on Mail-in Applications) $ 2,00
<br /> 4. TOTAL PERMIT FEE Add Lines 1-3 Above..__ , 12, _.
<br /> • * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
<br /> permitted work including materials,labor,profit,and other fixed costs. It is the amount to be charged
<br /> to the customer for the work done. If any material, equipment, labor or installations are furnished by
<br /> the owner, tenant or any other party,the reasonable marketvalue of such items must be added to the
<br /> estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the
<br /> amount of the job cost, the City may request the submission of a signed copy of the actual contract.
<br /> sn._may . A rs�-+ ! v� r ,a+Rr+
<br /> s�� U:.N;< {. C_,5.. S (.�mw� .-.,,.,...i,�S`�_"�.�:; �/, ��.F,�.r��.+ 1\e,/�/��.�.3.f. 7�,y�; ., 1.;4$r'� 1 k
<br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all
<br /> work in strict accordance with the ordinances of the City and the regulations of the State of
<br /> Minnesota, and certifies that all statements made on this application are complete, true and
<br /> correct.
<br /> Applicant's Signature( ()1i/(bt v �\�(,�d.� t. Date: /I- 2,Z.. ZO f ✓'
<br /> 3
<br />
|