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01/15/2013 TUE 11: 09 F;X 763 473 8565 Sabre Plumbing 6 )Heating 0007/007 <br /> I <br /> If above doesof apply;follow guidelin=s below: <br /> 1. ONTRACT TRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) <br /> ( 1 ( J q D'CCcj x.0125$ I' 2') gJ (contract price) (minimum$50.00) <br /> 2. TATE SURCHARGE 1 <br /> I, (1 0''I1'' x.0005 $ 410 <br /> (contract pri <br /> 3. POSTAGE&FIA/111DLING(Only on Mail-In Ap, ications) $ yvV <br /> i <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 1'2. 2 C.) ,. <br /> % * CONTII;ACT PRICE or JOB COST means the actual orestimated dollar amount charged for the <br /> permitted$work including materials, labor,profit,and oiler fixed costs. It is the amount to be charged <br /> n 1/15/20V; x,r '.Ito cthe cusisotnarffor t1rNs wbrk dottssa i3f an terial egaiiptnerit;_labor or installations are furnished by Z007/007 <br /> the owner, tenant or any other party, the reasonable market value of such items must be added to the <br /> estimated cost or contract price fo permit fee purposes. In the event that there is a dispute on the <br /> amount of the job cost, the City m y request the submission of a signed copy of the actual contract. <br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all <br /> work in strict accor.. ce with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certif s that all statements made on this application are complete, true and <br /> correct. <br /> Applicant's Signature: -,.,,)It;QUI1)41 Ct,t.Ljc :i:�t,�. Date: /-/J. 20 L''', <br /> i1), <br /> 3 <br />