City of Los Angeles CALIFORNIA

Size: px
Start display at page:

Download "City of Los Angeles CALIFORNIA"

Transcription

1 BOARD OF BUILDING AND SAFETY COMMISSIONERS City of Los Angeles CALIFORNIA v:- DEPARTMENT OF BUILDING AND SAFETY 201 NORTH FIGUEROA STREET LOS ANGELES, CA VAN AMBATIELOS PRESIDENT E, FELICIA BRANNON VICE PRESIDENT JOSELYN GEAGA-ROSENTHAL GEORGE HOVAGUIMIAN JAVIER NUNEZ miss ERIC GARCETTI MAYOR RAYMOND S. CHAN, C.E., S.E. GENERAL MANAGER FRANK BUSH EXECUTIVE OFFICER February 23, 2016 Honorable City Council Room 395, City Hall Los Angeles, CA RE : Refund Claim All Area Plumbing Inc Job Address : W. Santa Monica Blvd The Department of Building & Safety ( LADBS) received payment for building permit number from All Area Plumbing Inc in the amount of $ 135, customer is requesting for a refund in the amount of $ 111, due to the original permit being re-issued as three separate permits. This was done to accommodate project phasing requirements. The amount to be refunded is $ 87,882,82 ($111, less 20% administrative charge of $ 21,970,70, one stop surcharge of $ and miscellaneous fees $ are not refundable). Attached are copies of customer s cancelled check, permit and other supporting documents. The Department therefore recommends approval of refund claim This refund in accordance with LAMC sections and Raymd:, Chan, C. E., ST. E. General Manager Department of Building & Safety LADBS G-5 (Rev. 11/20/2014) AN EQUAL EMPLOYMENT OPPORTUNITY - AFFIRMATIVE ACTION EMPLOYER

2 > On CLo PC' RECEIVED SLA 2015 OEC 29 PH l 0 DBS AUTO SES PARTMENT OF BUILDING AND SAFETY 2 ACCS $S CITY OF L#S AN SELES FINANCE SERVIOH ZElTL SUlUlNS &SAP I I EZ JsND/Ne, /aj dopy vf V/A m/c.. CLAIM #_ I26AZI OS O) CD OO r+ CITY CLESK 330 s u e RECEIVED u iiy o t f t b u h r e PRINT NAME OF Claimant (Last) (First) Mailing Address (Street) (City; (Slate/Zip) All 'f /c'tot-jp/ttg l.56?w &*dcgf'rk{ Zerkti, /V y D?V?ZZ (Area Code) (Phone Number)? -zaz REFUND INFORMATION JOB LOCATION:!(X&? U/. MetofSA At&AcfZX 6? Amount Claimed $ i//s ts/,# v Ait ate Fees Paid: RECEIPT #/PERMIT #/REFERENCE #: tp'&zsg 779 ~7 /V&Y2- /7f7f STATE REASON FOR REQUESTING A REFUND - (Details): 7^?F^/r/r^! 'pe'm /</ brsn Yt-ifftscJ -kltrec^ 6tftov*U pcrnik &T rttyircw*. /Oe^ timbers am <2$ > isot/z -/OaOo-ZSIZ5, an<l!s<74z-f0cg0-z$lzr NOTE: A Claimant may be required to submit to examination under oath. (Charter Section 63.) Presentation of a false claim is a felony. (California Penal Code Section 72.) I HEREBY CERTIFY THAT THE ABOVE STATEMENTS ARE TRUE. /Z-Zi'15 remarks: -. L2 SIGNATURE AND TITLE OF CLAIMANT FOR DEPARTMENT OF BUILDING & SAFETY USE ONL AMOUNT APPROVED FOR REFVND$ DATE Audited by: Approved by: It 4 - Date: ~3~- f Date: Wtn LADBS-Finan. Frm 1 (4/2003)

3 W Santa Monica Blvd Permit #: f Plan Check #:M14LA03255 Printed: 12/21/15 08:31 AM Plumbing GREEN - MANDATORY Commercial Regular Plan Check Plan Check 1. PROPERTY OWNER is5 Event Code: City of Los Angeles - Department ofbuilding and Safety APPLICATION FOR PLUMBING PLAN CHECK AND INSPECTION Issued On: Last Status: 01/09/2015 Issued Status Date: 01/09/2015 SM PROPERTY LLC 2. APPLICANT INFORMATION (Relationship: Engineer) ROBERT 3. TENANT INFORMATION 2200 BISCAYNE BLVD MIAMI FL PARKWAY CALABASAS SUITE 30 CALABASSAS CA (818) CONTBACTOK. ARCHITECT & ENCINEER NAME ADDRESS CLASS LICENSE* PHONE * (C) ALL AREA PLUMBING INC (E) KRAUT, PETER A 1560 W INDUSTRIAL PARK ST COVINA, CA AMBRIDGE DR, CALABASAS, CA C M31498 (818) M14LA03255 S, APPLICATION COMMENTS Pressure at city main 66psi high, 57psi low. Hydraulic design for 4.8psi/100' for podium level. All other areas sized for 5psi/100'. 8" WM with RP. Booster pump rated for 250gpm@57I head. Gas company providing: DESCRIPTION OF WORK Installation of complete plumbing system for (40) story high rise with 3 levels ammenities and the rest are apartments. Includes domestic water with quadplex booster pump, waste and vent, storm drain, and medium pressure gas. Underground checked under " ". 7. CHECKLIST ITEMS: W Santa Monica Blvd COUNCIL DISTRICT: 5 9. APPLICATION PROCESSING INFORMATION Plan Check By: Irene Pool Tamayo For inspection requests, call toll-free (888) LA4BUILD ( ). Outside LA County, call (213) or request inspections via To speak to a Call Center agent, call 311. Outside LA County, call (213) OK for Cashier: Irene Pool Tamayo W/O #: For Cashier's Use Only Signature: NOTICE: Date: The work included in this permit shall not be construed as establishing the legal number of dwelling units or guest rooms. That number is established by a Building Permit or a Certificate of Occupancy. In the event that any box (i.e. 1-10) is filled to its capacity, it is possible that additional information has been captured electronically and could not be printed due to space restrictions. Nevertheless, the information printed exceeds that required by Section of the Health and Safety Code of the State of California. io. fee information FINAL TOTAL Plumbing Permit Total Permit Fee Subtotal Plumbing Permit One Stop Surcharge Final Fee Period Permit Sys. Development Surcharge Permit Issuing Fee Permit Supp. Issuing Fee Plan Check Balance Plan Check Subtotal Plumbing P. C. One Stop Surcharge P. C. Sys. Development Surcharge Green Building PC Fee' 23,810,37 Permit Fee: 111,951,07 135, , , / 2, , / , , , l'\ 1 I > 2 1? » 0 0 Payment Date: 01/09/15 Receipt No: Amount: 0 * P FN *P FN*

4 / >6 f LA Department of Building and Safety LA /9/2015 2:53:08 PM PLCJMBINGPERMIT-COMM ONE STOP SURCH SYSTEMS DEVT FEE PLUMBINGPERMIT-COMM PLUMBINGPERMIT-COMM MECHANICAL PC ONE STOP SURCH SYSTEMS DEVT FEE $103, $2, $6, $23.00 $0.00 $22, $ $1, Sub Total: Permit #: Receipt #: Payment Records Receipt No Total Amount: Check:

5 4. City of Los Angeles Department of Building and Safety REPORT ON CLAIM FOR REFUND Sent to. Location tua! Lfr CLAIM NO. J. OPERATING DIVISION REPORT AND RECOMMENDATIONS 1. Did Building and Safety perform any work for which the permit or receipt was issued 2. Are reasons given by claimant correct? NO YES,, YES NO... N.A. If NO," please explain Of the gross amount claimed, is the portion of the amount claimed pertaining to (these) particular item(s) correct? YES... NO Should be $ Hi 4^1,07? 4. If computations are involved, show computation on reverse side of this form or attach a separate^fje^b cz - 5. Did Department initiate action resulting in an error? YES... NO Should ~c... S.. If YES, please explain 6. Is claim over one year from date of expiration? If "YES, was permit extended? 7. Is a refund recommended? 8. Is this a duplicate permit or receipt of the same job or item? ^-~If YES, indicate other permit or receipt numbers) YES NO YES NO... YES... NO*... Explain under Item 10 YES...k^NO... t L23> r«s» m...sjfi-g...a erasers </>2> ><2: <n m S m So* CO o 9. ENTER THIS CLAIM FOR REFUND NUMBER ON YOUR OFFICE COPY OF THE RECEIPT AND/OR PERMIT, OR OTHER RECORD. DATE ENTERED O en /S > % r/ocoo- -psr/ zsr 10. FURTHER COMMENT OR CLARIFICATION OF THE ABOVE DATE IF NEEDED (use back of form if more space required): ?_wf$±r..<s,..«(...i ±h-,. 1 \...auu/lcxii Date... Division..X....Nobl'UlC' Signature of * Recommender Approved;- pk... Ext. Bureai (a. District or Branch Head 08-B & S FS-20 OL4/92)

6 r» Page 1 of 1 A / Stops - Images - Search image Front: A All Area Plumbing, Inc. H»Jaf Cmm PAY TO THE ORDER OF ALL AREA PLUMBING, INC. I860 W INDUSTRIAL PARK STREET COVINA, CA y DATE / If 090*337M4 E WallfMktvAKA. TES REQUIRED FOR AMOUNTS OVER $1, a Si-i?. tup" FOR.»B00D000E, Image Back: b1 l Ok OkLT SAT TO -l-rie CisSER G SLLL5 FAibSO City oi [un Buiiriirtcj and Safety j6 0 i- r SvOOo i l/5 /2 u 3 l e.: 5 3 : vo i n j.02g4s"&47 tj,» I- in m m QTf_GI oauk -i Item Details Deposit Details Routing Number Transaction Type: Credit Discretionary Data Details Deposit-id: Deposit Name: La-02 Created By. Eric Vega Deposited Item Details Maker Routing Number: Maker Serial Number: 6394 Deposited Item Amount: 135, Master Account Number/Master Account Name: /CITY OF LOS ANG Account Number/Account Name: /CITY OF LOS ANG Amount: 181, Type Code/Description: 301/COMMERCIAL DEPOSIT Posting Date: 01/12/2015 As of Date: 01/12/2015 Item Sequence Number: Ceo Id: CITYOFLA Deposited By: Eric Vega Maker Account Number: Description: Check Deposited Item Sequence Number: Discretionary Data Details Extemal-isn: Privacy, Security & Legal Copyright Wells Fargo. All rights reserved. 1/15/2016

7 ^ CLAIM FOR REFUND - PAYMENTS CLAIM# FEE FUND FUND AMOUNT DIS- ADJUSTED 20% NET TYPE TYPE PAID ALLOWED FEES RETENTlOh REFUND P-PR 48R/08/3228/3243 AP OSS 438/50/4659/ AP SYS 48R/08/4001 /3800 AP TOTAL

prct? " CiTY CLtRivi Grr GE 2016 FEB 16 AH 9:57 C1TYCLFRK KY >S. i^poty February 12, 201fe

prct?  CiTY CLtRivi Grr GE 2016 FEB 16 AH 9:57 C1TYCLFRK KY >S. i^poty February 12, 201fe February 12, 201fe Office of the City C'erk 200 North Spring Street Room 395 Los Angeles, CA 90012 Attn Clerk of the Council APN: 2039-021-013 CiTY CLtRivi Grr GE 2016 FEB 16 AH 9:57 C1TYCLFRK KY >S. i^poty

More information

GILCHRIST & RUTTER PROFESSIONAL CORPORATION. February 10,2017

GILCHRIST & RUTTER PROFESSIONAL CORPORATION. February 10,2017 GILCHRIST & RUTTER WILSHlRE PALISADES BUILDING 1299 OCEAN AVENUE. SUITE 900 SANTA MONICA, CALIFORNIA 90401-1000 TELEPHONE (310) 393-4000 FACSIMILE {310) 304-4700 E-MAIL: tcaape rfcm@gilch r I strutter,

More information

CITY OF LOS ANGELES CALIFORNIA

CITY OF LOS ANGELES CALIFORNIA CITY OF LOS ANGELES CALIFORNIA ERIC GARCETTI MAYOR CLAIRE BARTELS DIRECTOR OF FINANCE CITY TREASURER PARKING OCCUPANCY TAX COLLECTION BOND/ESCROW CASH DEPOSIT APPLICATION APPLICANT INFORMATION Legal Name

More information

Application for Florida Enterprise Zone Jobs Credit for Sales Tax Effective January 1, 2003

Application for Florida Enterprise Zone Jobs Credit for Sales Tax Effective January 1, 2003 Application for Florida Enterprise Zone Jobs Credit for Sales Tax Effective January 1, 2003 1. Business Name 2. Owner Name 3. Mailing Address City State ZIP 4. Business Location City State ZIP 5. Business

More information

LETTER OF PROTEST VIA PERSONAL SERVICE & VIA

LETTER OF PROTEST VIA PERSONAL SERVICE & VIA Maria Mojica 2501 Yorkshire Drive Los Angeles CA 90065 LETTER OF PROTEST VIA PERSONAL SERVICE & VIA E-Mail City Clerk 200 N. Spring, Room 395 Los Angeles CA 90012 Attn: Clerk of the Council RE: Single

More information

CITY of Los ANGELES CALIFORNIA ANTONIO R. VILLARAIGOSA MAYOR NOTICE OF HEARING. Regarding the property known as: 1130 S FEDORA ST

CITY of Los ANGELES CALIFORNIA ANTONIO R. VILLARAIGOSA MAYOR NOTICE OF HEARING. Regarding the property known as: 1130 S FEDORA ST BOARD OF BUILDING AND SAFETY COMMISSIONERS MARSHA L. BROWN PRESIDENT VAN AMBATIELOS VICE-PRESIDENT VICTOR H. CUEVAS HELENA JUBANY ELENORE A WILLIAMS CITY of Los ANGELES CALIFORNIA ANTONIO R. VILLARAIGOSA

More information

TRANSMITTAL IM'tE 09/30/16

TRANSMITTAL IM'tE 09/30/16 TO The City Council The City Attorney FHOM The Mayor TRANSMITTAL IM'tE 09/30/16 0150 10801-0000 COUMC'l FILE NO COUNCIL CI TFSICT rva Authority tor the Director of Finance to amend Contract No. C 125648

More information

CALIFORNIA ANTONIO R. VILLARAIGOSA MAYOR NOTICE OF HEARING. Regarding the property known as: W LINNET ST

CALIFORNIA ANTONIO R. VILLARAIGOSA MAYOR NOTICE OF HEARING. Regarding the property known as: W LINNET ST BOARD OF BUILDING AND SAFETY COMMISSIONERS MARSHA L. BROWN PRESIDENT VAN AMBA TIELOS VICE-PRESrDENT VICTOR H. CUEVAS HELENA JUBANY ELENORE A. WILLIAMS CITY of Los ANGELES CALIFORNIA ANTONIO R. VILLARAIGOSA

More information

SBA 504 LOAN APPLICATION

SBA 504 LOAN APPLICATION 222 N. 32 nd Street, Suite 200 Billings, MT 59101 Phone (406) 869-8403 Fax (406) 256-6877 www.bigskyfinance.org 825 Great Northern Blvd, Ste 301 Helena, MT 59601 Phone (406) 441-5447 Fax (406) 449-5678

More information

City of Los Angeles CALIFORNIA

City of Los Angeles CALIFORNIA BOARD OF BUILDING AND SAFETY COMMISSIONERS City of Los Angeles CALIFORNIA DEPARTMENT OF BUILDING AND SAFETY 201 NORTH FIGUEROA STREET 90012 VAN AMBATIELOS PRESIDENT E. FELICIA BRANNON RAYMOND S. CHAN,

More information

TRANSMITTAL

TRANSMITTAL 0150-10475-0000 TRANSMITTAL TO DATE COUNCIL FILE NO. The City Council SEP 11 2015 FROM The Mayor COUNCIL DISTRICT n/a Authority for the Director of Finance to execute an amendment Bank of New York Mellon

More information

CALIFORNIA ERIC GARCETT! MAYOR

CALIFORNIA ERIC GARCETT! MAYOR BOARD OF BUILDING AND SAFETY COMMISSIONERS City of Los Angeles CALIFORNIA DEPARTMENT OF BUILDING AND SAFETY 201 NORTH FIGUEROA STREET LOS ANGELES, CA 90012 VAN AMBATIELOS PRESIDENT E. FELICIA BRANNON JOSELYN

More information

LOS ANGELES POLICE COMMISSION

LOS ANGELES POLICE COMMISSION SANDRA FIGUEROA-VILLA ROBERT M. SALTZMAN MARIA SILVA Mayor EXECNTIVE DIRECTOR LOS ANGELES, CA 90012-4112 (213) 236-1400 PHONE (213) 236-1410 FAX March 23, 2015 RE: Auto Park Permit(s): 11333 S. La Cienega

More information

COA Professional Liability Plan

COA Professional Liability Plan COA Professional Liability Plan FOR MEMBERS OF THE CALIFORNIA OPTOMETRIC ASSOCIATION 3-462 H How to apply: Simply complete the application, enclose your premium check made payable to Mercer and mail to

More information

CITY OF LOS ANGELES Department of Building & Safety

CITY OF LOS ANGELES Department of Building & Safety CITY OF LOS ANGELES Department of Building & Safety BUILDING PERMIT CALIFORNIA ENVIRONMENTAL QUALITY ACT (CEQA) PROCEDURE FOR HISTORICAL MONUMENTS 11/2001 TABLE OF CONTENT I. REVIEWING PROJECT AND APPLYING

More information

Department of Growth Management

Department of Growth Management Department of Growth Management SWIMMING POOL SPA SERVICING CONTRACTOR Swimming Pool/Spa Servicing Contractor means a contractor whose scope of work involves, but in not limited to, the repair and servicing

More information

TRANSMITTAL TO ATE COUr^C II, FILE NO The City Council 7/07/15

TRANSMITTAL TO ATE COUr^C II, FILE NO The City Council 7/07/15 0120-17346-0000 TRANSMITTAL TO ATE COUr^C II, FILE NO The City Council 7/07/15 from The Mayor COUNCI. Cl STRICT 13 Echo Park Lake Sidewalk Repair Project - Transfer of Funds to the Department of Transportation

More information

CALIFORNIA ERIC GARCETTI MAYOR

CALIFORNIA ERIC GARCETTI MAYOR BOARD OF BUILDING AND SAFETY COMMISSIONERS City of Los Angeles DEPARTMENT OF CALIFORNIA BUILDING AND SAFETY 201 NORTH FIGUEROA STREET LOS ANGELES, CA 90012 VAN AMBATIELOS PRESIDENT E. FELICIA BRANNON \

More information

TO SUBMIT A CLAIM. Have you: Completed and signed the Claim Form? All incomplete forms will be returned and will delay your claim assessment.

TO SUBMIT A CLAIM. Have you: Completed and signed the Claim Form? All incomplete forms will be returned and will delay your claim assessment. TO SUBMIT A CLAIM HERE ARE THE STEPS TO SUBMIT A CLAIM Step 1... Gather all your original detailed receipts. Step 2... Complete and sign the Claim Form. Step 3... Complete and sign your Provincial Health

More information

13~Olw--g ? if::\:::~} <::"i~' C; i--- r'n. January 11, 2014 JOSEFINAOLIVAS A WIDOW 9402 WILMINGTON AVE LOSANGELES,CA 90002

13~Olw--g ? if::\:::~} <::i~' C; i--- r'n. January 11, 2014 JOSEFINAOLIVAS A WIDOW 9402 WILMINGTON AVE LOSANGELES,CA 90002 January 11, 2014 JOSEFINAOLIVAS A WIDOW 9402 WILMINGTON AVE LOSANGELES,CA 90002 City of Los Angeles Office of the City Clerk 200 North Spring Street Romm 395 Los Angeles, Ca 90012 RE: APN: 6046-0001-008

More information

APPLICATION FOR ASSIGNMENT OF LEASE

APPLICATION FOR ASSIGNMENT OF LEASE PROCEDURES 1. Have your proposed assignee fill out the attached application completely. 2. Use the checklist on the back of this sheet to be sure all information is included. 3. Attach a credit check and

More information

NEW BUSINESS CHECKLIST

NEW BUSINESS CHECKLIST NEW BUSINESS CHECKLIST Seminole County Occupational Business Tax Receipt Application completed and signed by an owner, partner, or officer of the corporation, or LLC. A Social Security or Federal ID number

More information

k v s? Los Angeles City Ethics Commission June 2, 2015

k v s? Los Angeles City Ethics Commission June 2, 2015 ns a w k * $ s v s? o. Los Angeles City Ethics Commission June 2, 2015 The Honorable City Council c/o Holly Wolcott, City Clerk 200 North Spring Street City Hall - 3rd Floor Los Angeles CA 90012 Re: Council

More information

Project Information Form. Date of Submission: Zoning District: Tax Map # (s): Project Size (Acres): City: State: Zip: City: State: Zip:

Project Information Form. Date of Submission: Zoning District: Tax Map # (s): Project Size (Acres): City: State: Zip: City: State: Zip: Project Information Project Type: Building Permit Project Information Form Date of Submission: Zoning District: Tax Map # (s): Project Size (Acres): Project Name: Project Project Description: Village of

More information

Continuing Disclosure Annual Report. Fiscal Year Ended: June 30, 2013

Continuing Disclosure Annual Report. Fiscal Year Ended: June 30, 2013 Alameda Public Financing Authority Local Agency Refunding Revenue Bonds (Harbor Bay CFD And Marina Village AD) Series 2010A and Subordinate Series 2010B Continuing Disclosure Annual Report Fiscal Year

More information

SBA 504 LOAN APPLICATION

SBA 504 LOAN APPLICATION 222 N. 32 nd Street, Suite 200 Billings, MT 59101 Phone (406) 869-8403 Fax (406) 256-6877 www.bigskyfinance.org Last Chance Helena, MT 59601 Phone (406) 441-5447 Fax (406) 256-6877 www.bigskyfinance.org

More information

APPLICATION TO RENT (AND RECEIPT FOR APPLICATION SCREENING FEE)

APPLICATION TO RENT (AND RECEIPT FOR APPLICATION SCREENING FEE) 1. Applicant History Community: Address: APPLICATION TO RENT (AND RECEIPT FOR APPLICATION SCREENING FEE) Please complete this form entirely in ink, noting "N/A" or "none" where applicable. Do not use white

More information

Property located at: Monthly Rental Rate: $ Property Manager: APPICANT #1. Name: Date of Birth: Social Security #: Address: Telephone: Address:

Property located at: Monthly Rental Rate: $ Property Manager: APPICANT #1. Name: Date of Birth: Social Security #: Address: Telephone:  Address: Asset Marketing & Property Management, Inc. 21202 Olean Blvd., Suite A-4 Port Charlotte, FL 33952 A FLORIDA LICENSED REAL ESTATE BROKERAGE CORPORATION Voice: 941-743-4000 Toll Free: 888-701-4001 Fax: 941-624-3000

More information

Master permit is a building permit obtained for the complete work on any project.

Master permit is a building permit obtained for the complete work on any project. Se 10-4. - Building permit fee schedule. (a) Definitions. Dry run is defined as the process of plans signed and sealed by the design team submitted for building permit but with a building permit application

More information

SUCCESSOR AGENCY CONTACT INFORMATION

SUCCESSOR AGENCY CONTACT INFORMATION Successor Agency ID: 145 County: Los Angeles Successor Agency: Santa Monica SUCCESSOR AGENCY CONTACT INFORMATION Primary Contact Honorific (Ms, Mr, Mrs) First Name Last Name Title Address Tina Rodriguez

More information

ERIC GARCETTI MAYOR EXECUTIVE DIRECTIVE NO. 24. Issue Date: May 30, 2018

ERIC GARCETTI MAYOR EXECUTIVE DIRECTIVE NO. 24. Issue Date: May 30, 2018 ERIC GARCETTI MAYOR EXECUTIVE DIRECTIVE NO. 24 Issue Date: May 30, 2018 Subject: Building "A Bridge Home" Suitable and safe shelter is a basic need, and the lack thereof can have a damaging effect upon

More information

Checklist for FIRST TIME APPLICANTS and RENEWAL APPLICANTS:

Checklist for FIRST TIME APPLICANTS and RENEWAL APPLICANTS: Linda DiBella Consumer Affairs/Home Improvement Phone: 845-808-1617 ext. 46024 Fax: 845-808-1930 linda.dibella@putnamcountyny.gov PUTNAM COUNTY HOME IMPROVEMENT CONTRACTOR REGISTRATION INSTRUCTIONS *Any

More information

Los Angeles ookt**40 World Airports 60'

Los Angeles ookt**40 World Airports 60' 400 00...04 Los Angeles ookt**40 World Airports 60' TM July 24, 2014 The Honorable City Council of the City of Los Angeles City Hall, Room 395 Los Angeles, CA 90012 LAX LA/Ontario Van Nuys City of Los

More information

PAYING FOR USC

PAYING FOR USC PAYING FOR USC 2017-2018 Welcome to the Trojan Family! We know you re looking forward to joining our academic community and taking advantage of all the university has to offer. In this brochure you will

More information

NEW ACCOUNT & CREDIT APPLICATION. SHIP TO: (If different from Bill To) How would you like to receive invoices? (Choose 1) Fax ( /Fax#)

NEW ACCOUNT & CREDIT APPLICATION. SHIP TO: (If different from Bill To) How would you like to receive invoices? (Choose 1)  Fax ( /Fax#) HOLIDAY HOUSE DISTRIBUTING NEW ACCOUNT & CREDIT APPLICATION New Request Update Existing BILL TO: Legal D.B.A.: Street Address: City: County: State: Zip: Contact: Title: SHIP TO: (If different from Bill

More information

Informacion en Español acerca de esta junta puede ser obtenida llamando al (213)

Informacion en Español acerca de esta junta puede ser obtenida llamando al (213) Informacion en Español acerca de esta junta puede ser obtenida llamando al (213) 978-1300 Kimberly Chemerinsky, President Daphne Brogdon, Vice President Jennifer Chung-Kim, Commissioner Christina Oh, Commissioner

More information

Building Permit Application

Building Permit Application A full service provider of Pennsylvania Uniform Construction Code (UCC) services. Uniform Construction Code Building Permit Application Porter Township LOCAL LIGHT-HEIGEL OFFICE CONTACT INFORMATION: T

More information

Dental Claim Statement

Dental Claim Statement Page 1 of 3 Sun Life and Health Insurance Company (U.S.) Employee Benefits Group Group Dental Benefits P.O. Box 81633, Wellesley Hills, MA 02481 https://ebg.sunlife.com Complete Part I - Employee s Statement.

More information

CITY OF LOS ANGELES CALIFORNIA

CITY OF LOS ANGELES CALIFORNIA JUNE LAGMAY City Clerk HOLLY L. WOLCOTT Executive Officer CITY OF LOS ANGELES CALIFORNIA Office of the CITY CLERK Council and Public Services Room 395, City Hall Los Angeles, CA 90012 General Information

More information

Checklist for FIRST TIME APPLICANTS and RENEWAL APPLICANTS:

Checklist for FIRST TIME APPLICANTS and RENEWAL APPLICANTS: Linda DiBella Consumer Affairs/Home Improvement Phone: 845-808-1617 ext. 46024 Fax: 845-808-1930 linda.dibella@putnamcountyny.gov PUTNAM COUNTY HOME IMPROVEMENT CONTRACTOR REGISTRATION INSTRUCTIONS *Any

More information

',7S'oiS'N> Los Angeles City Ethics Commission. June 20, 2016

',7S'oiS'N> Los Angeles City Ethics Commission. June 20, 2016 ',7S'oiS'N> Los Angeles City Ethics Commission June 20, 2016 The Honorable City Council c/o Holly Wolcott, City Clerk 200 North Spring Street City Hall - 3rd Floor Los Angeles CA 90012 Re: Council File

More information

Highlands County Building Department 501 South Commerce Avenue Sebring, FL (863) Fee Schedule FY 17-18

Highlands County Building Department 501 South Commerce Avenue Sebring, FL (863) Fee Schedule FY 17-18 Highlands County Building Department 501 South Commerce Avenue Sebring, FL 33870 (863) 402-6643 Fee Schedule FY 17-18 Right to collect fees per: FL Statu 125.56(2), 166.22 & 553.80 & County Ordinance Article

More information

Honorable Mayor and Members of the City Council. Jim DellaLonga, Director of Economic Development

Honorable Mayor and Members of the City Council. Jim DellaLonga, Director of Economic Development 14-J TO: Honorable Mayor and Members of the City Council ATTENTION: Jeffrey L. Stewart, City Manager FROM: Jim DellaLonga, Director of Economic Development SUBJECT: Consideration and possible action to

More information

Submittal Guidelines RFQ# Master Site Plan

Submittal Guidelines RFQ# Master Site Plan Submittal Guidelines RFQ# 18-006 Master Site Plan Instructions: Please provide six (6) hard copies and one electronic version. Architectural/Professional Services Number each page consecutively, including

More information

MINIMUM INSPECTION PROCEDURAL GUIDELINES FOR BUILDING ELECTRICAL RECERTIFICATION

MINIMUM INSPECTION PROCEDURAL GUIDELINES FOR BUILDING ELECTRICAL RECERTIFICATION CITY OF DORAL BUILDING DEPARTMENT MINIMUM INSPECTION PROCEDURAL GUIDELINES FOR BUILDING ELECTRICAL RECERTIFICATION INSPECTION COMMENCED Date: INSPECTION COMPLETED Date: INSPECTION MADE BY: SIGNATURE: PRINT

More information

s!' X % L, II II I ii 9^11^%^ ,, rvg « ~ ;j '"xj MICHAEL N. FEUER CITY ATTORNEY REPORT RE:

s!' X % L, II II I ii 9^11^%^ ,, rvg « ~ ;j 'xj MICHAEL N. FEUER CITY ATTORNEY REPORT RE: A?r d Hi sjm s!' X II m % L, II II I ri IU A & ii Ig StAi 9^11^%^ -51),, rvg «(VI m. 1 ' -V f! \l \ n*i 8 /L c ~ ;j & '"xj 1C5 r- ga -is MICHAEL N. FEUER CITY ATTORNEY REPORT RE: REPORT NO. 817-0236 JUL

More information

100-POINT IDENTIFICATION CHECK PER APPLICANT - must include photo ID & proof of income.

100-POINT IDENTIFICATION CHECK PER APPLICANT - must include photo ID & proof of income. TRADING HOURS: MON-FRI ~ 9am to 5:30pm SAT ~ 9am to 3pm Property : 100-POINT IDENTIFICATION CHECK PER APPLICANT - must include photo ID & proof of income. 40 points -Passport 20 points -Current Motor Vehicle

More information

CITY OF SONOMA 2017 FEE SCHEDULE INDEX EFFECTIVE FEBRUARY 13, 2017

CITY OF SONOMA 2017 FEE SCHEDULE INDEX EFFECTIVE FEBRUARY 13, 2017 ADMINISTRATION CA-00 Copy fee - ALL DEPARTMENTS - Unless specific document copy fee is stated. This applies to all printed material i.e. Development Code, General Plan, Minutes, Staff Reports, Agendas

More information

CITY OF INGLEWOOD Film Permit Application One Manchester Blvd. - Inglewood, CA (310) Fax: (310)

CITY OF INGLEWOOD Film Permit Application One Manchester Blvd. - Inglewood, CA (310) Fax: (310) CITY OF INGLEWOOD Film Permit Application One Manchester Blvd. - Inglewood, CA 90301 (310) 412-5500 Fax: (310) 330-5735 A film permit is required for the purpose of making any commercial motion picture,

More information

UNIVERSITY OF CALIFORNIA, IRVINE, DIVISION OF CONTINUING EDUCATION

UNIVERSITY OF CALIFORNIA, IRVINE, DIVISION OF CONTINUING EDUCATION UNIVERSITY OF CALIFORNIA, IRVINE, DIVISION OF CONTINUING EDUCATION BERKELEY DAVIS IRVINE LOS ANGELES MERCED RIVERSIDE SAN DIEGO SAN FRANCISCO SANTA BARBARA SANTA CRUZ University Programs, International

More information

RE: QDROs. Dear Potential Client:

RE: QDROs. Dear Potential Client: RE: QDROs Dear Potential Client: Thank you for your interest in my firm's QDRO services. My fee is $950 for the first QDRO and $750 for each additional QDRO required for your matter. Military Pensions

More information

To-Be Process Review Workshop

To-Be Process Review Workshop 1 To-Be Process Review Workshop Human Resources Taxes Location: ROSS Building Room: 130 Time: 8:00 am - 12:00 pm Date: 9/19/05 2 Workshop Logistics Tent Cards Rest Rooms Break Parking Lot 3 Workshop Agenda

More information

ADAM H. PUTNAM COMMISSIONER

ADAM H. PUTNAM COMMISSIONER FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES ADAM H. PUTNAM COMMISSIONER PROFESSIONAL FUNDRAISING CONSULTANT REGISTRATION APPLICATION Chapter 496, Florida Statutes 5J7.005 Florida Department

More information

NOTICE TO GENERAL RELIEF APPLICANTS

NOTICE TO GENERAL RELIEF APPLICANTS COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC SOCIAL SERVICES APPLICATION FOR GENERAL RELIEF WARNING NOTICE TO GENERAL RELIEF APPLICANTS Effective May 1, 1994, if it is determined that you have filed duplicate

More information

COUNTY OF SAN JOAQUIN VETERANS SERVICE OFFICE 105 S. SAN JOAQUIN STREET STOCKTON, CALIFORNIA TELEPHONE: 209/ FAX: 209/

COUNTY OF SAN JOAQUIN VETERANS SERVICE OFFICE 105 S. SAN JOAQUIN STREET STOCKTON, CALIFORNIA TELEPHONE: 209/ FAX: 209/ VRGIN1NA A. WIMMER VETERANS SERVICE OFFICER - COUNTY OF SAN JOAQUIN VETERANS SERVICE OFFICE 105 S. SAN JOAQUIN STREET STOCKTON, CALIFORNIA 95202 TELEPHONE: 209/468-2916 FAX: 209/468-2918 L4f a Thank you

More information

City of Titusville Gateway to Nature and Space

City of Titusville Gateway to Nature and Space City of Titusville Gateway to Nature and Space 555 SOUTH WASHINGTON AVENUE CUSTOMER SERVICE DIVISION TITUSVILLE, FLORIDA 32796-3584 (321)-383-5791 POST OFFICE BOX 2807 (32781-2807) Fax (321)-383-5848 Dear

More information

Checklist for FIRST TIME APPLICANTS and RENEWAL APPLICANTS:

Checklist for FIRST TIME APPLICANTS and RENEWAL APPLICANTS: Linda DiBella Consumer Affairs/Home Improvement Phone: 845-808-1617 ext. 46024 Fax: 845-808-1930 linda.dibella@putnamcountyny.gov PUTNAM COUNTY HOME IMPROVEMENT CONTRACTOR REGISTRATION INSTRUCTIONS Please

More information

Reseda Central Business District Community Design Overlay District

Reseda Central Business District Community Design Overlay District Reseda Central Business District Community Design Overlay District FILING INSTRUCTIONS 1. Read ALL instructions carefully. Missing or incomplete materials cause delays. 2. Before designing the project,

More information

TOWN OF HAMILTON, VIRGINIA License No.

TOWN OF HAMILTON, VIRGINIA License No. APPLICATION FOR BUSINESS OR PROFESSIONAL LICENSE FOR OFFICE USE ONLY TOWN OF HAMILTON, VIRGINIA License No. 53 EAST COLONIAL HIGHWAY License Fee HAMILTON, VA 20158 Penalty 2009 Interest Issued PLEASE SEND

More information

Homeowner Agent Web Table of Contents

Homeowner Agent Web Table of Contents Homeowner Agent Web Table of Contents CHAPTER 1 New Business Entry 1 Begin Full Quote 1 Applicant Information 2 CHAPTER 3 Search for an existing quote How to search a New Business quote 26 How to manage

More information

Application begins on page 3

Application begins on page 3 INSTRUCTIONS FOR COMPLETING DBPR ABT 6029 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR EXTENSION OF LICENSED PREMISES OR AMENDED SKETCH OF LICENSED PREMISES Application begins on page 3

More information

WHEN FILLING OUT THE APPLICATION: All information must be complete and signed by each applicant. The non-refundable application fee is $20.

WHEN FILLING OUT THE APPLICATION: All information must be complete and signed by each applicant. The non-refundable application fee is $20. WHEN FILLING OUT THE APPLICATION: All information must be complete and signed by each applicant. The non-refundable application fee is $20.00 per person. Processing will not begin until the application

More information

Professional Liability Insurance

Professional Liability Insurance Professional Liability Insurance Underwritten by Liberty Insurance Underwriters Inc., a member company of Liberty Mutual Insurance Benefits Guide for CPhA Members Why should employed pharmacists purchase

More information

CITY OF JENKS COMMERCIAL BUILDING PERMIT P.O. Box N. Elm Jenks, OK 74037(918)

CITY OF JENKS COMMERCIAL BUILDING PERMIT P.O. Box N. Elm Jenks, OK 74037(918) CITY OF JENKS COMMERCIAL BUILDING PERMIT P.O. Box 2007 211 N. Elm Jenks, OK 74037(918) 299-5883 CERTIFICATE OF OCCUPANCY: DATE RECEIVED: BUILDING ADDRESS: LOT: BLOCK: ADDITION: SECTION: TOWNSHIP: RANGE:

More information

THE 201 TRAVEL NURSE TAX ORGANIZER

THE 201 TRAVEL NURSE TAX ORGANIZER THE 201 TRAVEL NURSE TAX ORGANIZER AFFORDABLE HEALTH CARE ACT In order to comply with the new law we need some information regarding HEALTH INSURANCE. If you (and your family) were insured all year long,

More information

Rental Application for Residents and Occupants

Rental Application for Residents and Occupants Rental Application for Residents and Occupants Each co-resident and each occupant over 18 must submit a separate Application. M E M B E R Date when filled out: ABOUT YOU Full name (exactly as it appears

More information

CALlFORNIA ANTON IO R. VI LLARAIGOSA MAYOR NOTICE OF HEARING. Regarding the properly known as: 162 W 42ND ST

CALlFORNIA ANTON IO R. VI LLARAIGOSA MAYOR NOTICE OF HEARING. Regarding the properly known as: 162 W 42ND ST -. IJOARU OF BUILDING AND SAFETY COMM1SSTONERS MARSH/\ L. BROWN PRESIDENT l tel ENA J UBANY VICE-PRES ID ENT VAN AMBI\TIELOS VICTOR 1-1. CUEVAS ELENORE 1\. WILLI AMS CITY OF Los ANGELES CALlFORNIA ANTON

More information

CAMPAIGN TREASURER'S REPORT SUMMARY. Monetary. Expenditures $ I. Office Account $ I 1. Total Monetary $

CAMPAIGN TREASURER'S REPORT SUMMARY. Monetary. Expenditures $ I. Office Account $ I 1. Total Monetary $ CAMPAGN TREASURER'S REPORT SUMMARY (1) Gary Resnick OFFCE USE ONLY Name (2) 2800 NW 10 Avenue Address (number and street) City, State, Zip Code 0 -w...- Check here if address has changed (3) 1&1' ~ECEV~

More information

Town of Braselton Occupational Tax Certificate Application NEW: Return original copy before commencing operations

Town of Braselton Occupational Tax Certificate Application NEW: Return original copy before commencing operations Town of Braselton Occupational Tax Certificate Application NEW: Return original copy before commencing operations RENEWAL: REMIT TO: Return original copy before November 15 th Town of Braselton 4982 Hwy

More information

SECTION 110A FEE TABLES

SECTION 110A FEE TABLES SCHEDULE OF FEE TABLES: SECTION 110A FEE TABLES 1A-A 1A-B Building Permit Fees 1. New construction permit fee 2. Alteration permit fee 3. Standard permit fee for plumbing, electrical and/or mechanical

More information

PAYROLL DIRECT DEPOSIT FORM

PAYROLL DIRECT DEPOSIT FORM Check one: PAYROLL DIRECT DEPOSIT FORM If you are wanting to deposit to multiple accounts, please complete a separate form for each account. Set up new account Change existing account Store # Add additional

More information

UNIVERSITY OF CALIFORNIA, SAN DIEGO

UNIVERSITY OF CALIFORNIA, SAN DIEGO / BERKELEY DAVIS IRVINE LOS ANGELES MERCED RIVERSIDE SAN DIEGO SAN FRANCISCO SANTA BARBARA SANTA CRUZ OFFICE OF THE AS SOCIA TE VICE CHANCELLOR CAPITAL PROGRAM MANAGEMENT TEL: (858) 534-2177 FAX: (858)

More information

Poulsbo July 3 rd Fireworks July 3, 2015 At Anderson Parkway in Downtown Poulsbo, Washington VENDOR CONTRACT

Poulsbo July 3 rd Fireworks July 3, 2015 At Anderson Parkway in Downtown Poulsbo, Washington VENDOR CONTRACT Poulsbo July 3 rd Fireworks July 3, 2015 At Anderson Parkway in Downtown Poulsbo, Washington VENDOR CONTRACT BUSINESS NAME ADDRESS CITY STATE ZIP BUSINESS PHONE # E-mail Address ATTACH A LIST OF YOUR PRODUCT

More information

REPORT OF THE CHIEF LEGISLATIVE ANALYST

REPORT OF THE CHIEF LEGISLATIVE ANALYST REPORT OF THE CHIEF LEGISLATIVE ANALYST DATE: August 7, 2013 TO: Honorable Members of the City Co cil FROM: Gerry F. Mille~ Assignment No.: 13-07-0616 ChiefLer~a}5 t council File No.: 11-0106 AMENDMENT

More information

One and two family residences... $ Mobile Homes... $73.73 Commercial Building... $ All other miscellaneous applications... $44.

One and two family residences... $ Mobile Homes... $73.73 Commercial Building... $ All other miscellaneous applications... $44. EXHIBIT "A" BUILDING PERMITS, HOUSING CODE AND MOBILE HOME PERMIT FEES Page 1 of 9 I. APPLICATION FEES (Non-refundable) One and two family residences... $147.59 Mobile Homes... $73.73 Commercial Building...

More information

Rental Application Policy. Est. Monthly Water: $ Security Deposit: $ Lease Processing Fee: $159.00

Rental Application Policy. Est. Monthly Water: $ Security Deposit: $ Lease Processing Fee: $159.00 19405 Martin Rd Roseville MI 48066 Champion Property Management 12345 Twelve Mile Rd. Warren, MI 48093 Office Phone: 586-978-4444 Fax: 586-806-6420 Look4Rental.com champpropmanagement@gmail.com Rent: $

More information

TABLE OF CONTENTS PAGE INTRODUCTION 1 IMPORTANT INFORMATION IMPORTANT DATES TO REMEMBER 3 MASS PAYMENT PLAN 4 5 MASS PAYMENT INFORMATION 6

TABLE OF CONTENTS PAGE INTRODUCTION 1 IMPORTANT INFORMATION IMPORTANT DATES TO REMEMBER 3 MASS PAYMENT PLAN 4 5 MASS PAYMENT INFORMATION 6 TABLE OF CONTENTS PAGE INTRODUCTION 1 IMPORTANT INFORMATION 2 2012 IMPORTANT DATES TO REMEMBER 3 MASS PAYMENT PLAN 4 5 MASS PAYMENT INFORMATION 6 CD INSTRUCTIONS 7 9 CD TRANSMITTAL FORM 10 WIRE REMITTANCE

More information

PARK ON BURKE APARTMENT HOMES

PARK ON BURKE APARTMENT HOMES PARK ON BURKE APARTMENT HOMES APPLICATION PROCESS GUIDELINES Welcome to our community. Thank you for choosing the PARK ON BURKE APARTMENTS as your new home. In order to reside in our community, we require

More information

Florida. Sales Tax Tales:

Florida. Sales Tax Tales: Sales Tax Tales: Objectives Registration and Account Maintenance Sales Tax Transactions Use Tax Tax Rates How to File and Pay Fact or Fiction New businesses must register at their nearest service center.

More information

PRE-QUALIFICATION SUBMITTAL PACKAGE FOR GENERAL CONTRACTOR PRE-QUALIFICATION FOR THE VETERANS SPORTS PARK AT TUSTIN LEGACY, CIP NO.

PRE-QUALIFICATION SUBMITTAL PACKAGE FOR GENERAL CONTRACTOR PRE-QUALIFICATION FOR THE VETERANS SPORTS PARK AT TUSTIN LEGACY, CIP NO. PRE-QUALIFICATION SUBMITTAL PACKAGE FOR GENERAL CONTRACTOR PRE-QUALIFICATION FOR THE VETERANS SPORTS PARK AT TUSTIN LEGACY, CIP NO. 20043 IN THE CITY OF TUSTIN 300 CENTENNIAL WAY TUSTIN, CALIFORNIA 92780

More information

WELCOME TO YOUR NEW APARTMENT! Date APPLICATION FOR RESIDENCY

WELCOME TO YOUR NEW APARTMENT! Date APPLICATION FOR RESIDENCY WELCOME TO YOUR NEW APARTMENT! APPLICATION FOR RESIDENCY APT# ADDRESS RENT TENTATIVE M/I DATE LEASE TERM PERSONAL INFORMATION PLEASE PRINT FULL NAME HOME PH: ( ) LAST FIRST MIDDLE INIT DO YOU HAVE A PET?

More information

Welcome to Bank of the West!

Welcome to Bank of the West! Welcome to Bank of the West! Please keep these important documents with your Deposit Account Disclosure for Personal Accounts booklet and retain them for future reference. Schedule of Fees and Charges

More information

INSTRUCTIONS FOR COMPLETING DBPR ABT 6004 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO CHANGE OF OFFICER/STOCKHOLDER APPLICATION

INSTRUCTIONS FOR COMPLETING DBPR ABT 6004 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO CHANGE OF OFFICER/STOCKHOLDER APPLICATION INSTRUCTIONS FOR COMPLETING DBPR ABT 6004 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO CHANGE OF OFFICER/STOCKHOLDER APPLICATION Application begins on page 3 If you have any questions or need assistance

More information

INSTRUCTIONS FOR COMPLETING DBPR ABT 6026 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR ALCOHOLIC BEVERAGE EXPORTER REGISTRATION

INSTRUCTIONS FOR COMPLETING DBPR ABT 6026 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR ALCOHOLIC BEVERAGE EXPORTER REGISTRATION INSTRUCTIONS FOR COMPLETING DBPR ABT 6026 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR ALCOHOLIC BEVERAGE EXPORTER REGISTRATION If you have any questions or need assistance in completing

More information

Request for Proposals for Banking Services Date Issued: November 25, 2015

Request for Proposals for Banking Services Date Issued: November 25, 2015 Request for Proposals for Banking Services Date Issued: November 25, 2015 Proposals must be received no later than 5:00 p.m. on Monday, December 28, 2015 at the following address: City of Malibu Attention:

More information

CITY OF LOS ANGELES HOUSING + COMMUNITY INVESTMENT DEPARTMENT RENT STABILIZATION DIVISION RENT ADJUSTMENT COMMISSION (RAC) AGENDA

CITY OF LOS ANGELES HOUSING + COMMUNITY INVESTMENT DEPARTMENT RENT STABILIZATION DIVISION RENT ADJUSTMENT COMMISSION (RAC) AGENDA CITY OF LOS ANGELES HOUSING + COMMUNITY INVESTMENT DEPARTMENT RENT STABILIZATION DIVISION RENT ADJUSTMENT COMMISSION (RAC) AGENDA Thursday, 12:00 P.M. Garland Office Hearing Room 1200 West 7th Street 1st

More information

INVITATION TO BID RSU-21 Schools Additions and Renovations (Referendum 6-10) Bid Package Concrete - Mildred L Day School Sprinkler and Pump Room

INVITATION TO BID RSU-21 Schools Additions and Renovations (Referendum 6-10) Bid Package Concrete - Mildred L Day School Sprinkler and Pump Room INVITATION TO BID RSU-21 Schools Additions and Renovations (Referendum 6-10) Concrete - Mildred L Day School Sprinkler and Pump Room Project Information Project 14669: RSU-21 Schools Additions and Renovations

More information

INSTRUCTION SHEET FOR NON-RESIDENT (OUT-OF-STATE) DRUG OUTLET (PHARMACY)

INSTRUCTION SHEET FOR NON-RESIDENT (OUT-OF-STATE) DRUG OUTLET (PHARMACY) Vermont Secretary of State Office of Professional Regulation VERMONT BOARD OF PHARMACY National Life Building, rth, FL 2 Montpelier, VT 05620-3402 Ph: (802) 828-2373 or 828-1505 Fax: (802) 828-2465 E-Mail:

More information

WORKSHEET FOR 501(c)(3)

WORKSHEET FOR 501(c)(3) WORKSHEET FOR 501(c)(3) Consultant: Affiliate: Affiliate Code: Phone: Date: Nevada Post Office Box (additional fees apply) YES NO Assignment of Assets (additional fees apply) YES NO 1. CLIENT CONTACT INFORMATION:

More information

DBPR ABT-6014 Division of Alcoholic Beverages and Tobacco Change of Location/Change in Series or Type Application

DBPR ABT-6014 Division of Alcoholic Beverages and Tobacco Change of Location/Change in Series or Type Application DBPR ABT-6014 Division of Alcoholic Beverages and Tobacco Change of Location/Change in Series or Type Application STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION NOTE This form must

More information

Hanover Development Inc.

Hanover Development Inc. Hanover Development Inc. Development Pro Forma 124 West Colorado Glendale California Glendale California Report Date: May 29, 2013 Report Time: 12:31:08 PM FINANCE SOURCE PERFORMANCE MEASURES Source of

More information

DÚN LAOGHAIRE RATHDOWN COUNTY COUNCIL MOBILITY AIDS HOUSING GRANT SCHEME APPLICATION FORM

DÚN LAOGHAIRE RATHDOWN COUNTY COUNCIL MOBILITY AIDS HOUSING GRANT SCHEME APPLICATION FORM MAG 1 DÚN LAOGHAIRE RATHDOWN COUNTY COUNCIL MOBILITY AIDS HOUSING GRANT SCHEME APPLICATION FORM The Mobility Aids Housing Grant will only be a contribution toward the total cost of the works. Any shortfall

More information

BUILDING PERMIT-GENERAL INFORMATION

BUILDING PERMIT-GENERAL INFORMATION Inc. Village of New Hyde Park BUILDING PERMIT-GENERAL INFORMATION THIS INFORMATION IS FOR BUILDING PERMITS ONLY. PLUMBING PERMITS MUST ALSO BE APPLIED FOR ALL PLUMBING WORK 1. Fee MUST be paid at time

More information

Green Acres Community

Green Acres Community Community Qualification Guidelines All applicants must complete the entire application in full prior to March Joint Powers Authority processing the application. Including all phone numbers, account numbers

More information

APPLICATION FOR GRADING PERMIT

APPLICATION FOR GRADING PERMIT Section 1.0 Property Location: APPLICATION FOR GRADING PERMIT Fill in all information completely Property Owner Name & Address Engineer Name & Address Applicant Name & Address Phone Number Email Address

More information

COLLIER COUNTY BUSINESS TAX RECEIPT INSTRUCTIONS PLEASE MAKE CHECK PAYABLE -- COLLIER COUNTY TAX COLLECTOR COLLIER COUNTY TAX COLLECTOR

COLLIER COUNTY BUSINESS TAX RECEIPT INSTRUCTIONS PLEASE MAKE CHECK PAYABLE -- COLLIER COUNTY TAX COLLECTOR COLLIER COUNTY TAX COLLECTOR COLLIER COUNTY BUSINESS TAX RECEIPT INSTRUCTIONS PLEASE MAKE CHECK PAYABLE -- COLLIER COUNTY TAX COLLECTOR SUBMIT APPLICATION TO: COLLIER COUNTY TAX COLLECTOR BUSINESS TAX DEPARTMENT 2800 N. HORSESHOE

More information

FBN Requirements (SB 1467)

FBN Requirements (SB 1467) FBN Requirements (SB 1467) Effective January 1, 2015, pursuant to Senate Bill 1467, the Los Angeles County Registrar/Recorder County Clerk s Office will require a Notarized Affidavit of Identity form to

More information

BUSINESS LICENSE APPLICATION (801) E STAGECOACH RUN, EAGLE MOUNTAIN, UT

BUSINESS LICENSE APPLICATION (801) E STAGECOACH RUN, EAGLE MOUNTAIN, UT BUSINESS LICENSE APPLICATION (801) 789-6634 1650 E STAGECOACH RUN, EAGLE MOUNTAIN, UT 84005 WWW.EAGLEMOUNTAINCITY.COM Thank you for your interest in opening your business in Eagle Mountain City. The following

More information

ENTITY / EMPLOYING BROKER LICENSE APPLICATION (LI-212) ARS & R

ENTITY / EMPLOYING BROKER LICENSE APPLICATION (LI-212) ARS & R Arizona Department of Real Estate (ADRE) Licensing Division www.azre.gov DOUGLAS A. DUCEY GOVERNOR JUDY LOWE COMMISSIONER 2910 N. 44 th Street Suite-100 PHOENIX, AZ 85018 ENTITY / EMPLOYING BROKER LICENSE

More information