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04/23/2018 HON 1Q: 52 FAx 763 a73 8565 S�bre Heating & Ai.r Cond f�003/009
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<br /> �l � a�� Y 1� Y �i �y1�A�lYi7�:T' IF. �:����4 I�N;` y�� ��(���h�t;Y�l',�
<br /> ;'A.�;tS;a.�'llal,•�f�''a7pJ..1.1�',4M���.1,��i(:�ii¢�Mi..�hti:�:Nrk �i ,d �)4.�Pddq��:,o'��`!;�,"•44:,l,(�u,1'����6@hLA�..,'�',ib.�.�^1l�ltl"��7°���
<br /> FIXTURE BSMT iar 2Nb pTHER �lXYUR� �SM'C 1 r 2"o pTHER
<br /> TYPE Fbor Floor TYPE Floor Flaor
<br /> . .. ..........__..--�------ -�-----��---- -- �..� ...... ,,.... �.,....,.... ..w....4.,�
<br /> Water Closet , Floor Dralna `
<br /> Lavatory � y Sewer E)ector
<br /> Bathtub � Laundry Tray
<br /> 8hower � Washer �
<br /> Kltchen Slnk � Watar Heater �
<br /> Disposal � Water 8o�ttener
<br /> Dlshwasher ` ` Wet Bar (
<br /> S�Icocks � Miscellaneo�s
<br /> 'I
<br /> 1. CONTRAICT PRICE •is 1.259�0 of oontra�t prlce wlth a(Mlnlmum Fs� of$50,00�
<br /> - jA?,..'SS.zI, x .o�z� � 2�a+��
<br /> (contract prlce) (minlmum$50.00)
<br /> 2. 9TATE SURCHARt3�
<br /> ---- - - �a �..��.Z� , X.a�5 $. ..,... . ..�9��� _
<br /> (contract p�ce)
<br /> 3. PGSYpGE a NANDLING (Only on Mail-In Applications) $ 2.00
<br /> 4. TOTAL PERM17 F�E(Add Lines 1-3 Abova) S ���•� _
<br /> ,� " CaNTRACT PFtICE or JOS COST means the actual or esUmated ddlar amount oharged for the
<br /> permltted wor'k InCluding materials, Isbor, praflt, �nd other fbced costs. It is the emount to be charged to
<br /> � the customer for the work done. If any material, equlpment, labor or Installataans are furnlshed by the
<br /> owner, tenent or any other pe�ky, the reesonable market v�lue of euoh itams mu�t bs added to the
<br /> estimated cost or contre�at p�ice for permit fee purpoaea, In the eve�t that there la a dlspute on the
<br /> amount of the job cost, the Clty m�y request fhe submisslon of a signed oopy of the aatual contract.
<br /> The undersigned heraby applles to the Clty for Issuance of a Plumbing Permit, agreea to do all work In
<br /> atrlct accordance with the ordinances of the City and the regulations of the State of AAlnnesQtai, and
<br /> certlfles that�II stabBments made on thla appllcetlon are complete,#rue and correat.
<br /> AppUcant's Slgnature; _ ANL�bY �,�Ar(rU�X�G(�±�_ _ _ _ Date: '�'-�,�• Z0,/,�
<br /> Bullding�iflcial/Inspector: Date;
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