HomeMy WebLinkAbout15-16392 %
. CITY OF ZEPHYRHILLS
r 5335-8TH STREET
�sis��so-oo20 16 92
FENCE PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 16392 Address: 36301 DELTA GOLD CT LT#5
Permit Type: FENCE ZEPHYRHILLS, FL.
Class of Work: FENCE/NEW Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: SILVERADO
Est. Value: Parcel Number: 04-26-21-0060-00100-0050
Improv. Cost: 3,012.00 OWNER INFORMATION
Date Issued: 6/26/2015 Name: WALTON, RICHARD & BONNIE
Total Fees: 45.00 Address: 36301 DELTA GOLD CT
Amount Paid: 45.00 ZEPHYRHILLS, FL 33541-2737
Date Paid: 6/26/2015 Phone: (813)355-3888
Work Desc: INSTALL 42 x6 VINYL FENCE/72 X 4 VINYL PICKET FENCE
CONTRACTOR S APPLICATION FEES
BIG DOG FENCE INC (813)907-9877 FENCE 45.00
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Ins ections Re uired
FINAL
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to any one of the following reasons: a)wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections called d)work not ready for
inspection when called e) permit not posted on job site fi� plans not at job site g)work not accessible.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances
CONTRAC OR PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
RROTECT CARD FROM WEATHER
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iJ I IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII
2015102000
tcpt:1693276 Rec: 10.00
)S: 0.00 IT: 0.00
�16/26/2015 T. S. , Dpty Clerk
NOTICEOFCOMII�NCEMENT �RULR S 0'NEIL,Ph D PASCO CLERK & COMPTROLLER
�60R66K 19213m PG �2�2
Permit No.
Property Identification No. Dy'2�O`Z�y 0�[R� �L�J��0� `bOs�
TI�UNDERSIGNED hereby give informs you that the improvement will be made to certain real property,ead in accordance with
Section 713.13 of the Florida 5tatutes,the following information is provided in this NOTICE OF COMML�NCEMEIVT.
Ji�ve,r��lo-�h�s; l� P�3 61 Pl��l.��lod`! Lo�'S
I.Description of property(legal desaipt on)
a)Su�eet Address:,31! b � h tfl` ��re� Y � �
2.Deneral description of improvements: �
�'--�t�
3.Owner Information - �
, a)Nameandaddress: /[�[�'IGrc� C y N��n)e ,4 g1�►� � �3p1 ► �� &1 rf �edQ�;ll���'t. 335�/�
b)Name and address of fee simple titleholder(if other than owner}
c)I�erest in property
4.Cantracmr Informaflon - p P
a)Name�d address: � C \/ � S Y,7
b)Telephone No.: / . O Fax No.(Opt)
S.Siuety Infocmation
a)Name and address•
b)Amount ofBond: -
c)Telephone No.: Fax No.(Opt)
6.Lender
a)Name and address:
Phone 210.
' 7_Identity of persoa within the State of Florida desi�ated by owner upoa whom nofices or other doc�ents may be served:
, - a)Name and addcess:
b)TelephoneNo.: FaxNo.(Opt)
8.In addition to h�sel�owneT designates Uic following petsoa to receive a copy ofthe Lienor's Natice as pmvided"m Section
713.13(I)(b),Florida Statutes: _
a)Name and addsess:
b)TelephoneNo.: t � FaxNo.(Opt)
I9_Expiration date of NoNce of Commencement(the expicarion date is one yeaz from the date of recording unless a diffeient date is
I sp�ed): : 1
� -
WARNIl�TG TO OWNER: ANY PAYMENTS MADE BY THE OWNER AF1'ER THE EXPIRATION OF THE NOTICL OF
� COMMLNCEMENT ARE COPISIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,SECTIOIV 713.13,
FLORIDA STATIITES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVF.MENTS TO YOIIR PROPERTY.
' A NOTICE OF COMMENCEMENI'MUST BE RECORDED AND POSTED ON THE JOB S1TE BEFORE THE FIItST
INSPECTION. IF YOU 1NTEND TO OBTAIN FINANCING,COPISULT YOUit LEI�IDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECOIiDING YOUR PIOTICE MMENCEN[ENr
srarE or Fr,oxma /�/ •
COUNTY OF PASCO G v- � � � "
� � of Own or c's Au�m�d OSicedDi otlPazNer enagc o N � ¢
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P't e Y � o r z
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The f in hvmeni rvas aclmowledged before me ' day of ���.�.. 20�,by = in d � °
��nj t-��N as (tYP�of authority,e.g o fficer,hustee,atWmey N � 'X o L
wh instrmnerrt was } = w •— �,
name of on behatf of o �• y
in fact)fo[ � P�Y w a • �
1 � N o
N E
ersonal Known OR Produced Identification Nohry Signature c> >• E E �
P �y � � o �
_ � U o. �
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Type of Identifica6on Produced _�f� Name(print) � � m
• ` \G,���„yo '
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Verification pursuant to Section 92.525,Florida Statutes.Under pena16 erj�sy,7 declare that I have read the foregoing and that = o_
I e to the best of m Irnowled e and belief. '�o`*•'o-�:=
the facts stated in it are riv Y g , H 1,
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Si ofNeturnl Pcrson Sigung Abova
F�AMSlNOC,mRaW
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. s�sasaoozo City of Zephyrhills Permit Application Fax-ai��aaoozi
Building Department
a'
Date Received phone CanWct for Pertnittln
�r
e � y
Owner's Name �/ � � Owner Phone Number ��r7 " �"
Owners Address � ,T� !JQ L Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Slmple TiUeholder Address
JOB ADDRESS �r I � � 33�y0 LOT# �
SUBDIVISION 1r `/ I PARCEL ID# — � �O� "dO�O � O
(OBTAINED FROM PROPERTY TA7(NOTICE)
WORK PROPOSED B NEW CONSfR e ADD/ALT 0 SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM � OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q
DESCRIPTION OF WORK 1t� yt � -
BUILDING SIZE SQ FOOTAGE � �L HEIGHT 7� %' '
r'� ��
QBUILDING $ � D/Z'� VALUATIONOFTOTALCONSTRUCTION
DELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $
�MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
�GAS Q ROOFING Q SPECIALTY � OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREf� Y/N
Address License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREA Y/N
, Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N �E cURREn Y/N
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y I N FEE CURRQ. Y/N
Address License#
OTHER COMPANY � � �( ,
SIGNATURE �cis7�x� Y/ FEE CURRET Y/N
Address V V � Q d7�J License#
1111111111111111111111111111 11 111 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
RESIDENiIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
Minimum ten(10)working days after submittal date. Required onsite,ConsWcQon Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 tlumpster,Site Work Permit for subdivisions/large projects
COMMERCIAL Attach(3)complete sets ot Building Plans plus a LiTe Safety Page;(1)set of Energy Fortns.R-O-W Permit for new construction.
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormvrater Plans wl Silt Fence installed,
Sanitary Facilities 8 1 dumpster Site Wor1c Permit for all new projects.All commercial requirements must meet comptiance
SIGN PERMIT Attach(2)sets of Engineered Plans.
"'•PROPERTY SURVEY required for all NEW construction.
Directions:
Fill out application completely.
Owner&ConVactor sign back of application,notarized
If over$2500,a Notice of Commenc¢ment Is required. (A/C upgrades over$750D)
" Agent(for the conVactor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
' NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed°restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work,they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work,they are advised to contact the Pasco County Building Inspection Divisior�Licensing Section at 727-&47-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the"contractor Block"of this application for which they will be responsible. If you, as the owner sign as the
contractor,that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings,change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07,as amended. The undersigned also understands,that such fees, as may be due,will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a"certificate of occupancy"or final power release. If the project does not invoive a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County WatedSewer Impact
fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended): If valuation of work is$2,500.00 or more,I
certity that I, the applicant, have been provided with a copy of the "Fiorida Construction Lien Law—Homeowner's
Protection Guide"prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the"owner",I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the"owner"prior to commencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating construction,zoning and land development. Application is
i hereby made to obtain a permit to do work and installation as indicated. I certify that no work or instaliation has
commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other govemment agencies may apply to the intended work, and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
Army Corps of Engineers-Seawalls,Docks,Navigable Waterways.
I - Department of Health 8� Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US Environmental Protection Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
' I understand that the following restrictions apply to the use of fill:
- Use of fill is not allowed in Flood Zone"V"unless expressly permitted.
- If the fili material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
' "compensating volume"will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
- If the fill material is to be used in Flood Zone "A" in connection with a permitted buiiding using stem wall
construction,I certify that fill will be used only to fill the area within the stem wall.
' - If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fiil is found to adversely affect adjacent properties,the owner may be cited for violating
� the conditions of the building permit issued under the attached permit application,for lots less than one (1)
, acre which are elevated by fill,an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER,I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate,cancel,alter,or
, set aside any provisions of the technical codes,nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans,construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six(6)months after the time the work is commenced. An extension
� may be requested, in writing,from the Building Official for a period not to exceed ninety(90)days and will demonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COM NCE ENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN D OBT N FINANCING,CONSULT '
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR O F MENCEMEN
� FLORIDA JURAT(F.S.117.03)
OWNER OR AGENT CONTRACTOR
' Subscribed and swom to(or aRrtned)before me this Subscribed and swom to(or affirmed)before me this
by 6y
Who is/are personally known to me or haslhave produced Who is/are personally known to me or hasfiave produced
as idenfification. as identification.
Notary Public Notary Public
Commission No. Commission No.
Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped
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BIG DQG FENCE INC. t�ate: � �8' � zot�
i 39116 ELdiAN dRiVE `- �
WESLEY'CHAPEL, F� Home Phone: ��1,'3 – 3�� – 3���'
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33545 { i�°�-��:,-=r°-= '. Bus. Phane:
E Mabile Fhone•
Tel, {81'3� 907-9877 Fax. Mumber: -
Fax. {813� 994-7827 EmafL• 2;c..l,�;�ctil�c��1 7 L rrr►?Cs..r i.t.�t,� �
EmaiL serviceCbigdo�fence.com EmaiL•
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PROPQSAL AND CONTRACT
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CUSTOMER: 12�1 t�� � 1`�v L'1 i'i i 'L C,.,t c.�.��� +�-� Subdivision: S i i v e�-c�d;� �'c�.�c4.
ADDRESS: :3� :�� � D�l-t��.�-�l d C-#', ; city_2�.1, c-1,�t1 s��L zip Code �:���//
�i JOB SITE: ��i�•.�– � City Zip Code
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�'otal Height 4' -5' -6'-_- 1Nood;.F'�essureaTreated
Post Spaced b'-8'-10' -i2' i `Board an Board: -W/tat
ChcrinZ.ink ShadowBox: �- Wt�at
Color: Galv Brn B(k Grn _Stockade:Con`vex-Concave
Fabric: _Mesh x ga. Picket:5paced_D'E-P�
Tension Wire: 14ga 9ga No Runners: 1-1/4'� - 2x4"
B/Wire: 3-b strd: 15.5ga 12_5�a Pkts DE: 1/2x4"-5/8x 4"-5,5" � � �
i'op Rail: i-318"-1-5I8" �a. Line Past: 4x4-4xG �';;,�`�
Line Post: 9-5l8" - 2" _ga. Gate Past 4x4-4x6-6x6
, End Post: 2-1/2" - 3'" �a. DECO POSt: GOtIItC,M1�2F Construction Nates:
, C/Post: 2-1/2"- 3" �a � Virivl; whi � ,tan
Sgt/G Post: 2-1/2" -3" ,�a Style c��i`I'E✓-�A,,�S Pi��'� Bottp"m,of Fence:.�follow grade_string straight w/grade_tevel wlgrade
DrlG Post. 2-i/2"- 3" _ga Styie G����S�G i f�v, ✓ . Post tied ta cancrete w/1"weep hole"prevents sintcing"
� Gate Frames: 1-318"-9-518"-2" Line Past: "Pkt�i 5"Pkt-5"P 3 `
� �v� Gate Post Set in Concrete i00 tbs beti sh�ped at bottom
�� Wa(k'Gate Openinq End Post: 4"Pkt� 5"Pkt 5"P � Gate Nin�e Past{PVC��Heavy Watt rli-Beam Atum. (nsert
� 36"w 42°w UPost: 4"Pk �{5"Pkt 'P 1 ✓ Line Post set in 5Q tbs ncrete
48"w _ G/Post: 4',P_ �5"Pkt 5"P � � Hardware SS{PVC} �hite �black
60"w "i i i��v Lo (f T P)';�i- Aluminuin Grn ; Brnz Hardware Steel{Wood}black painted
72"w–�— Wht - Btk - 8rn� - Tan .�ans ,Gothic ,_..New Eng `Ball �Federation
Drive Gat"e Openinst Styte ✓Ext �inC _Satar
Line Post 2" -2-1/2" Cross Street:
Sin�le Swing:_/_h.x w: End Post 2" -2-1!2" SEC 7WS RNG �ot# 5 Block 7
Double Dnve: ._/_.,,h.x w. C-Post 2"- 2-1/2" THIS PROPOSAL MAY BE WITHDRAWb!BY BIG DOG FENCE lNC. !F NOT
Rott: _/_h.�_w. S/Gate Post 2"- 2-1/2"- ACCEPTED WITHIN 30 DAYS. THIS PROPOSAL SHALL BECOME A
Cantilever: _/�h.x w. DrlGate Post 2"-2-1/2"- BtNDING CONTRACT UPON ACCEPi'ANCE.
Permit!ncluded: ✓Yes _,_NO 1 SEE REIJERSE SIDE FOR TERMS OF CONTRACT. I
^Not Required �
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�, ' �01I��RACT
•1 AGREEMENT made this ���day of; t��"t! ,2015,by and beriveet�.BTG DOG FENCE iNC.hereinafter
referred ta as"BDF"and i:t�.t�, � 1'�.:�,,7�i L t,:u.1�v� hereinafter refened to as"Customer."
In consideratian of the mutual cavena�afis contained herein and the coz�sideratzon to be paid by G`�istamer ta Big Dog Fence
Inc.,it is a�reed as follows: -
1.Customer shall pay to Big Dog Fence 1nc.the sum of$ >v�� �?.`'`� or the work described herein.Payment shall be
made to BDF by the Customer upon completion,unIess otherwise specified.
7.BI3F agrees tv fi�mish ati necessary labar and materials to canstruct tlie improvements described
l�erein as per the specificatians and drawings,if any,shocvn an the reverse side.BDF further warrants ail materials wi11 be as
specified and that all work will be completed izi a workman}ike manner according to standard practices.
3.If this is a residential job,Customer repi�esents and warrants that halshe is the ou�ner of the proper[y or Rennter described
herein.If this is a commercial job,Customer represents that he/she is the awner ofthe property described herein,ar an
Authorized Representative,ar Agent representing the following Business(es)or Organization,titled as,
or renterlconb•actor who has a contract ta
improve property owned by
and that part of the improvements contracted for by the owner includes the work described herein.
4.Customer agrees to locate,relocate,stake and clear fence linas,and assumes full responsibility for same.Custamer
agrees to indemnify and hold BL7F harmless for any liability or damages that may result from Cnstomer's failure to properly
iocate,stake and elear fence lines.Customer fu'rther agrees to advise BDF of any deed,subdivision,or other restrictions which
may affect constructian of the fence or athar izripravements to be canstructed by BDF,and agrees to indemnify and hold BDF
harrnless from any liability or damages that may resu]#because af the faiiure ta comply with deed,subdivision,or other
restrictions. '
f
5.BDF will call the lacal U61ity Lacating Service for public utiliries only.BDF does nat assume any respansibility or
Iiabitity for any damage of any nature ta underground obstructions not marked or flagged by customer.Custorner agrees to
ciearly"mark"any underground abs#rucfions ather than public utilities in the area of the fence line or the irnprovements to be
constructed by BDF.Custamer assnmes responsibility for any damage to underground obsh�uctions caused by Custorner's
failnre to Iacate and mark accurately with paint!ar ila;s,their existence.For purposes of this Agreement,undezground
oUstructions include but are not 1"united to all isripxovements constructed underground includzng utility pipes,sprinkier pipes,
cables,wires,foundations,and the Iike. !
6.It is agreed by and between the parties,tiiat any alteration or deviation from the above specifications involving extra cost
is ta be perfflrmed by BBF and wiil become an extra charge over and above the price stated herein.
7_Customer agrees to pay in futl the price shated herein upon compietion of work.Any failure to pay within three{3}days
after completion of wark,exclnding Sundays and Holidays sl�all be considered a defauit and BD�shall ba entitled to recaver
the full amount of the invoice plus interest(fmance charge)at the rate af 1 1l2%per month(1$%ger at2ium)until the contract
price is paid in full.In the event it becomes necessary for BDF ta take collection action,Customer agrees to pay all costs of
collectians including reasonable attorney's fees and costs.
8.It is agreed between the parties that BDF`witl retain�I25.00 from deposit if said contract is canceIled by custamer and
cUStomer further a�,�rees to a 25°te restocking fee'pltis return freight cost for all arders.No retum far custom arders.
9.It is further agreed between the parties that the fencing materials shall remain personal property�tnti}the cantract price is
paid in full.In the event the Custamer fails to pay the contract price,BDF shall ha�e the right to peaceably repossess and
remove ali materials instailed by it on the premises.Customer further agrees that BDF sha11 have all of the rights of a secured
pariy,as tha same is defined under the Florida Uniform Commercial Cade,and that said rights shall be cumulative and in
additian to any other rigl�ts which BDF inay have in accordance with Florida Law.
10.Process&Handling fee flf3°lo on all creclit card sales.
11_BDF is not xesponsible far warping or cracking of woad products�
12.BDF wiii warranty labor for installation of xesidentiaUcommercial fence for a period of 1 yeaz.
I3.BDF will wairanty labor for instailation,(residential/commercial gate aperator)for period of 90 days.
2 4.This ab eement is the entire agreement of tt�e parties and cannot be changed except in writing signed by bath parties.
There are no warranties or representations e:�cept as are expressed lterein.8�F speci�caliy disclaims all EXPIZESS and
1MPLIED WARRANTIES,including any WARRt1NTY OF MERGHANT ABII,ITY ar FITNESS FOR A PARTICULAR
PURPOSE. �
IN WITNESS WIiEREOF the partias have Hereunto signed their names on the day and year first above written_
� Additianal I.nforma�ion BIG DOG PENCE INC.,Alan Lanier
I $}�: f�..�C��Z �LL�r.t¢..
Down Payment 50°fo:� 1�C'�.�� Customer:_ X��2�,�^���Lt1 �—
�
Balance Due Upon Cornpletion:$ /:�e.''�.�� � Print: `� �(����} �� ��L.�f�'
Title:
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