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Change Order Item 5.8 <br />Official Receipt - Indian River County <br />CDPR103 - Official Receipt <br />Trans Number <br />Date <br />Post Date <br />Payment Slip Nbr <br />2014091085 <br />9/19/2014 2:42:04 PM <br />9/19/2014 <br />PT 2014040855 <br />Address: 1225 5TH ST SW METER ROW <br />Owner: INDIAN RIVER COUNTY COA #: <br />Permit Type: ELC Job Desc: SEE ADDITIONAL INFO <br />Applicant: KING , GEORGE, GLENN <br />DBA: COMPLETE ELECTRICAL SOLUTIONS LLC <br />Swr Meter. Wtr Meter: <br />Payor. COMPLETE ELECTRICAL SOLUTIONS LLC <br />Fee Information <br />Fee Code <br />Description <br />GL Account <br />Amount <br />Waived <br />REVISION <br />PLAN REVISION FEE <br />1-441032-322030 <br />$50.00 <br />Total <br />Payments <br />$50.00 <br />Payment Code <br />VISA <br />Account/Check Number <br />Amount <br />000004 <br />$50.00 <br />INDIAN.RIUER COUNTY BU <br />1UERO BEACH, S F 532960 <br />772-567-8000 <br />1ERNIHAL ID.: 09881238090829 <br />LISA <br />ttati 12884 EXP:t*/# SWIPED <br />SALE <br />BATCH! 8083% INV: 000004 <br />Ser 19, 14 19:04 <br />RRN, 83968884 AUTH: 046856 <br />TRH REFa; 464162673174156 <br />VALIDATION CODE: ZNZR <br />APPROVED <br />DESCRIPTION _____TOTAL $50.00 <br />HICHOLE ARNOLD <br />CUSTOIIR COPY <br />Total Cash <br />Total Non Cash <br />Total Paid <br />$0.00 <br />$50.00 <br />$50.00 <br />Cashier/location: BLDLK / 1 <br />User BLDLK <br />ae$c( A rfA <br />pDroke <br />ve <br />4 Close Construction <br />0 Other <br />.$~airs d ed Signature Cost Code <br />jab # 5e5 y Date 0'9- 2'2, .31) IV <br />'000/XP Printed: 9/19/2014 2:43:04 PM <br />106 <br />