IWS PLUMBING COMPANY PERMIT NUMBRER:
TSBPE RESPONSIBLE PLUMBER
LICENSE NUMBER: M9864 5025 SAUNDER RD, SUITE 103, FORT WORTH TEXAS 76019 _________________
(817) 5634170 PLUMBING WORK SERVICES ACTIVIES AND PERMIT CONTACT
I, _________________________________________________________, the legal private property owner of the below listed property, understand, that by signing this contract I am attesting to the Local Plumbing Jurisdiction that I have authorized IWS Plumbing Company to prepare the necessary construction documents and submit such documents along with a request for plumbing permit(s) for the plumbing work service activities requiring plumbing permit(s), be issued in my behalf, for the necessary plumbing services to be performed: (See Reverse of this form for Description(s) of plumbing work service activities requiring permitting and inspections by the Local Plumbing Jurisdiction:_______________________________________________________________________________________________________ ________________________________________________________________________________________________________________ _ Terms and Conditions Financial responsibility for the payment of fees and/or charges associated with the preparation of the construction documents(s) and the request for plumbing permit(s) which include charges for site plans, construction plans & drawing(s), consulting charges, plumbing permit fees, and other administrative charges and fees associated with the requested plumbing permits(s) is the responsibility of the private property owner. The property owner understands IWS Plumbing requires a down payment of $_____________.00 which is not refundable once the required plumbing permits have been requested. The private property owner understands that such funds shall be credited to the final billing statement. The private property owner acknowledge that in the event that the deposited amount exceeds $5000.00 such funds shall be deposited in a trust account of IWS Plumbing Company and withdrawn by IWS Plumbing Company as charges are incurred by the private property owner. Financial responsibility for the payment of materials and supplies, disinfection and required certified testing, and labor charges incurred by IWS Plumbing Company during the performance of the plumbing work service activities required during the completion of services under the requested permit(s) are the private property owners. As the private property owner I understand that a 25% restocking fee shall be assessed on all plumbing materials or products purchased by IWS Plumbing Company that are not used during the construction project if the reason for the change is solely a customer change(s) to original plans, construction documents and requested permit(s) and materials are not used or needed. The Private Property owner understand that the plumbing work service activities to be performed as repairs, installation of plumbing supplies or products to the private property, for which, the plumbing permit(s) is issued, may required the private property to become code compliant with the current adopted State of Texas Plumbing Code(s), ordinances and laws of the Local Plumbing Jurisdiction, Manufacturer’s product listing and installation requirement(s), and the requirements of the State of Texas OSSF Authority’s septic system(s) under 30 TAC 290, requirements and specifications as part of the issued permit(s)’s permitting and inspection processes. The private property owner here in acknowledges they have been informed that failure to comply with plumbing permits requirements could result in civil or criminal charges, administrative fines and the potential disconnection or denial of public utility service(s), i.e. water, sewer, gas and electrical connections. (Note: In situations where there is no local permitting authority available, the plumbing work service activities shall be performed as prescribe by adopted State of Texas Plumbing code(s) and the State of Texas OSSF Law under 30 TAC 290 Rules. The private property owner acknowledge that he/she shall not hold IWS Plumbing Company negligent or liable for any charges, which he/she may incur due to job completion delays, charges or fee(s) that may be incurred as a result of the permitting and inspection processes or additional charges or fee(s) IWS Plumbing Company may incur. The private property owner(s) authorized IWS Plumbing Company to charge his/her account, where such charges are a direct result of the requirements and specifications made by the Local Plumbing Jurisdiction Authority. The private property owner acknowledge that under no circumstances shall charge(s) or fee(s) for services rendered and performed by IWS Plumbing Company or subcontractors during the plumbing work service activities authorized by an issued permit(s) be withheld under the terms of this contract. All such charge(s) and fee(s) must be paid in full upon demand for such payment. The private property owner acknowledge that in the event such payment(s) are not tendered upon demand for such payment he/she shall be required to pay an amount of not less than 1.5% per month on the outstanding balance or a late fee of not more than 10% of the entire job cost. The private property owner further acknowledge(s) he/she shall be held liable for any and all charge(s) or fee(s) IWS Plumbing Company may incur in the collect of such debt(s) including administrative, collection assistance fee(s), attorney fee(s) and court cost associated with the collection of this debt. The Private property owner understand that IWS Plumbing Company has the right to file criminal charges for theft of service if the final statement is not paid within 10 days of demand for services rendered by IWS Plumbing Company and/or subcontractors.
Customer Signature: ____________________________________________________ Date: ______________________________________ ____________________________________________________________________________________________________________________________________________ _
The undersigned is a representative of IWS Plumbing Company and has the authority to accept the above request for IWS Plumbing Company for plumbing work service activities and/or plumbing permits where such work service activities are to be performed under an authorized plumbing permit, to be issued by the Local Plumbing Jurisdiction Authority in the Name of IWS Plumbing Company or an IWS Plumbing Company Representative or subcontractor. IWS Plumbing Company, Representative: __________________________________ Date: _______________________________________ ____________________________________________________________________________________________________________________________________________ _ Custer Name: _______________________________________________________ Time of Dispatch: ___________________ Reason for Permit New construction Private Property ________________________________________________________ Time of Arrival: ____________________ Plumbing Leak Address: Backflow Device Repl _______________________________________________________ Time of Departure: ____________________ Commode Repl Stop Repl HOME PHONE #: (__________)__________ __________ DAY TIME PHONE #: (_________)_______________________ Water Heating Equipment Rep
____________________________________________________________________________________________________________________________________________ _ TSBPE AND TCEQ CONTACT INFORMAT
Questions regarding the mandatory compliance with the adopted State of Texas Plumbing code(s): Contact the Texas State Board of Plumbing Examiners, Enforcement Division, PO Box 4200, Austin, Texas 787654200 or Call (800) 8456584. Questions regarding the mandatory OSSF requirements: Contact the TCEQ, P.O. Box 13087, Austin, Texas 787113087 or Call (512)2396133 Member WTS Association IWS Plumbing Company Form #: 101 (January 1, 2006) www.wtsassocation.com 18779748353 Copyright 2006 IWS Plumbing Company