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44/18/2018 WED 13: 06 FAX 763 473 8565 Sabre Heating & Air Cond 0003/006
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<br /> FIXTURE BSMT "IsT ...2ND OTHER FIXTURE BSMT 15T 2N° OTHER
<br /> TYPE Floor Floor TYPE Floor Floor
<br /> Waler Closet ' + 5 Floor Drains
<br /> Lavatory ` j 5 Sower Ejector
<br /> Bathtub ' Laundry Tray
<br /> Shower
<br /> 1' ' Washer i
<br /> Kitchen Sink Water Heater
<br /> Disposal Water Softener ._
<br /> Dishwasher ` Wet Bar
<br /> Silicocks '2„• Miscellaneous
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<br /> 1- CONTRACT PRICE *is 1.25%of contract price with a (Minimum Fee of$50.00)
<br /> OQ x.0125 $ U
<br /> (contract price) (minimum$50-00)
<br /> 2. STATE SURCHARGE
<br /> x.0005 $
<br /> (contract price)
<br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
<br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ 131.2•
<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 to
<br /> the customer for the work done. If any material, equipment, labor or installations are furnished by the
<br /> owner, tenant or any other party, the reasonable market value 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 submissiont of a signed copy of the actual contract.
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<br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in
<br /> strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and
<br /> certifies that all statements made on this applicationl\IL44,L4nd%41
<br /> are complete, true and correct.
<br /> Applicant's Signature: 4( Date: ''I 1.ioi I( _
<br /> Building Official/ Inspector: Date:
<br /> Page 2
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