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Commercial( ) New( ) Rcplaccm~t( ) ( )Dctachcd '~! I. * s ' ' [ <br /> <br />2, Location of Instalhfion <br /> <br />3. Contractor Information <br /> <br /> ~) o~, ~, or ~side ~ the com~etca <br />( ) I ondc~mnd ~at I ruust ~s~r as a c~st~Q~ c~cmr ff ~C S~ ~ sold or offered for sale b~o~ or u~n cmplefion, <br /> <br />( ) I ~ b~ my own g~oral c~traam, <br /> <br />If I him subcontractors, I will hire only subcontractors registered wi& ~hc Construction Ccatractors Board. <br /> <br />~ [ ~mge my mind and do ~m a gemr~ ~ntmc~r. I ~ ~ct ~ a cmmemr who is mgls~ wi~ ~e ~stmo~on Contract.s goard, an~ wi~ <br /> <br />( ~I am a rcgls~md bu~d~ OR tc aut;fi~ ~ufivc o~ a m~te~ b~, <br /> <br />4. Fee Schedule <br />A, (1} Manufactured Home <br />orModalarUnitPlac~meaqConnecdon @ $.~3~0~{/~'~ C- AddiQ~al~speefim <br /> (2) 8tateFec ~ 20,~=~ ~ orR~s~fi~ <br /> (3) State Su~ha~e ~ ~= /~. ~5 <br /> ~ ........... ~ ,~. ~~7~~ <br /> <br />B. (1) Mfg,'d Structure S~rage <br /> ~ $ 25,~ = <br />(2) ~g,'d Structure S~ge Renewal ~ 25.~ ~ ~ <br />(3) 7ming Sumha~e (15,~ if applicable) ~ 15.~ = ~ <br /> <br />@ $60.00=__ <br /> <br />D, Invcsdgation Fee <br /> <br />E, Other insp~ction~ not llstcd <br /> @ 40,00 Far hour (2 hour minimum) <br /> <br /> (~. $40,00 =__ <br /> <br />TOTAL= $ ~/~.~'~O <br />RECEIVI': ffffS7 <br /> <br />This. fcc c~rs ~ manufactured ~tmc[um ~a~mc~t, plumbing ~ncczi~, cl~t~c~ ~cctlon a~d mechanical connccdom 5iCe ~valuatio~ ~c.pi[c pc~it, clcctdca <br /> <br /> <br />