HomeMy WebLinkAbout1990, 10-03 Permit App: 90005335 Re-roofPARCEL NUMBER:
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INFORMATION WORKSHEET
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STREET ADDRESS:
CITY/STATE/ZIP:
SUBDIVISION:
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BLOCK: LOT: ZONE: — DISTRICT:
LOT AREA:_ F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS:- # OF DWELLINGS: .WATER DISTRICT:o
OWNER: I(�.�> PHONE:Cl
— —
MAILING ADDRESS:-
CITY/STATE/ZIP:
DDRESS. CITY/STATE/ZIP:
CONTACT:. e`�_ Qj6—y PHONE `) c .--C�f — // %D' yC 3VI
SETBACKS: — FRONT: -- LEFT: RIGHT: REAR:
PERMIT USE: /��e G�A-�0' / %.s �,.., �i�f,� 74o 77' '
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR: �c ylcQ h C Q PHONE:
MAILING ADDRESS: /,�
ARCHITECT/ENGINEER: PHONE: -
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
BUILDING DIMENSIONS: x (WIDTH X DEPTH) SQ. FT.:
REQUIRED PARKING: # HANDICAP: SEWER (Y/N): HYDRANT:
II 3. CONTRACTOR'S RECEIPT
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Pay to:
INSTALLATION INVOICE,, . I* 3,'16 5 7 0
j Date paid:
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Date
L
I
E DIV.
WORK
ORDER #
CUSTOMER'S
NAME
PERMIT
NO.
DATE
COMPL
INSTALLER
CHARGES
CONTRACTOR'S INSTRUCTIONS
FOR FILLING OUT INSTALLATION INVOICE
1. In Section "A", fill in business name and mailing address in upper left -
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hand box.
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2. a. INVOICE FOR LABOR ONLY. Using the information on the
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GOTC, complete Section "A" indicating the division, work order
number, customer's name, date of completion and charges for labor
performed.
b. INVOICE FOR MATERIAL AND LABOR.
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A purchase order will be given with the GOTC for any material
you are to furnish on a job, such as: a special plenum for an
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add-on air conditioner, pipe for water softeners, etc. When sub -
mitting your invoice, follow Step 2a and list your labor charges
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only. On the next line, in the column titled "Work Order #", put
the letters "P.O" and the purchase order number. Indicate the
. TOTALS - 1
(FOR USE BY CASHIER) AMOUNT
customer's name and the charges for the material supplied.
CHECK # .-�
c. If you work for more than one Sears store, submit a separate
invoice for each store.
All supporting detail must be attached.
3. Total the amount of the invoice & enter opposite word `Totals'. Do
Not Enter Anything Opposite Words `Check #'.
I certify that the installations listed above have all
been completed satisfactorily in accordance with the
4. Remove the #4 copy and retain for your records. This will allow you
specifications furnished me.
to have a copy of all bills submitted but not paid. Attach all GOTC's
to support the entries, sign and date the invoice at the bottom of
Section "A" where indicated.
5. Submit invoice to the Installation Office to process for payment
(DATE) (CONTRACTOR'S SIGNATURE)
15400 REV. 10-69 (INSTRUCTIONS FOR CONTRACTOR PRINTED ON 3RD COPY)