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Page : 3 of 5 03/25/2016 05 : 50 AM TO: 19522494616 FROM: Paul schumacher PHONE #
<br /> 312750027 '
<br /> i t .110
<br /> PLUMESINO:FIXTURES.SEING OSISTALLED. '• ' - ' '..-: ': .'...' ' ----'-'''.•-.:
<br /> .z,!kf: OTHER: 4;X•ri,i RE e-S-ttit't.' t'':: 2l".' OTHER
<br /> TYPE Froor - Fir TYPE . Fioer .. Finor
<br /> Water Closet Floor
<br /> ,,...........
<br /> Lavatoni
<br /> t.f
<br /> ' Sewer Eiector
<br /> F
<br /> ' .'. .
<br /> l
<br /> ..„„„.. . . ,
<br /> • KAchen Sink ! .7
<br /> thAter'Hewer
<br /> t ,
<br /> . Diseosat 'Water Softehet
<br /> Otanwasher s Wet 3ar
<br /> . , .
<br /> :t&itt:,;*ciks, . misoteit-orteo.us
<br /> „......'' '
<br /> 41 CONTRACT PRICE * isl 25% of contract price with a(Minimum Fee of$50.00)
<br /> ) t)46,ulin St-):',`,,C1•0
<br /> 2 STATE SURCHARGE
<br /> 000$ $
<br /> ..„,'
<br /> ontract price i
<br /> 3 POSTAGE&HANDLING?Offiy.:.11 VZ(t.in ,t40.04.:tortiOnSi ‘'(
<br /> 4. TOTAL PERMIT FEE lAdd Lines 1-2 Above) S
<br /> t CONTRACT PRICE or .JOB COST means the attli at or estimated dollar amount charged for the
<br /> permitted work inducting rnateriais, labor, profit, and other fixed costs. It is the amount to be charged to
<br /> the customer for the work done if any materiat equipment,. tabor or instatrations are furnished by the
<br /> c.ls'ner tf,:tharit Cir ,Ssy r.it net' VSny, tnie -reasio habit rrtiire* v.F"f
<br /> d .:.',.?.:Wi,r :.:', `,'7'0 nl.ri,',::, once fbw 04. 1-,r‘ t ft ,, tit.,i it i',),DiSe 1'':. ,.Mi?.. eii eitl!:. t i-i.i,)f rt r>.', ,o.i.', ',.,' :;11 .rd•.,lte on tr:itt.
<br /> amount of the lob cost the City may re&west the submission of a signed copy of the actual contract
<br /> PLUMBING PeckOtt'OPLIdATION AGREEMENT
<br /> The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in
<br /> strtOtt erdordance oi.t-iffh the vrtfinences tof thie City ad the redi.rlattons at hife Sitatei 0 !tidto,:n,eittitt8
<br /> t,; (,:yi ere r.,z.r.rortte,„ •tin:,..te a(-:,z, ,::;,c.,4r4,c1;;.
<br /> . ,4*: :, p .:):iii,„),„,,,*,....,.,I,„:
<br /> Applicant's Signature: 4.:(1..4,4tr —i ,-:-.,-.4-,',rt.,-*,„4:,- Date
<br /> Rullding Official/Inspector4 . ,, ,,,,,,„,,,,__ 3/Z.“0,&,_
<br /> /
<br /> /A44 Dare
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