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HomeMy WebLinkAbout16-17517 CITY OF ZEPHYRHILLS � , - 5335-8TH STREET (813)780-0020 17517,--� BUILDING PERMIT ' r` PERMIT INFORMATION � LOCATION INFORMATION � - Permit Number: 17517 Address: 38421 COTTONWOOD PL Permit Type: MECHANICAL ZEPHYRHILLS, FL. Class of Work: A/C CHANGEOUT Township: Range: Book: Proposed Use: MOBILE HOME PARK Lot(s): Block: Section: Square Feet: Subdivision: DRIFTWOOD Est. Value: Parcel Number: 02-26-21-021 B-OOG00-0010 Improv. Cost: 3,778.00 � OWNER INFORMATION Date Issued: 6/27/2016 Name: THOMPSON, SHARON Total Fees: 55.00 Address: 38421 COTTONWOOD PL Amount Paid: 55.00 ZEPHYRHILLS, FL. 33542 Date Paid: 6/27/2016 Phone: 813-713-1880 Work Desc: A/C CHANGE OUT 2 TON HEAT PUMP CONTRACTOR $ � " � APPLICATION FEES � � BAHR'S PROPANE GAS &A/C, INC. A/C CHANGEOUT 55.00 �� Ins ections Re uired DUCTSIN TALLED DUCTS IJ�ISUL��D� . FINAL cp r. REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or first reinspection,whichever is greater,for each such subsequent reinspection. NOTICE: In addition to the requirements of this permit, there maybe 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. ' "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing,consult with your lender or an attorney before recording your notice of commencement." Complete Plans,Specifications Must Accompany Application.All work shall be performed in accordance with � City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. CO RACTOR SIGNATURE PERMIT OFFI R ' PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED ' PROTECT CARD FROM WEATHER e�saso-oazo Ci#y of Zephyrhills Permit Application Fax 813-780.002� - ; Building Department oat,�����,�� ry _ � � u f,�/.3 ��' � - .3 . z! ; ` Rhone Coritsct��far Parmittlri .,: Owner's Name � A�4 N D , S�lt1 Qwner Phone Namber g -�� 7� '! 8�+� Owner's Address .3 � �..'�I �O p�V Gy!o6�C1 Owner•Phone Number �, � �, , Fee 51enple�TltlehblderName �w � Owner Phone Number _� � , .'r7,�—' . ._ , �'�'�. , Fee Simple Titleholder Address �. �y� "� ' ' J09 ADDRESS 3 g � � � �O �/!3�/ l,�Q��r!� LpT# �,� / ' SU9D�tV131QN � � � PARCEL ID# ' - ` , ;� � ' �(OBTAINED FROM�PROpERTY TAK NCTICE) ii WORK PRt1POSEp .. NEW CONSTR � � ADDJAI:T ��� SIGN Q Q DEMOLISH • , .-� � e , INSTAL•L 8 V -. ':REPAIR` � PROPOSED tiSE. Q�= SFR �] COMM `� O'fFiEt2 . TYPE OF CONSTRUCTION, '�` `BLOCK�' . [']'� � �F.RAME � STEEL Q� � , - DESGRIPTION OF WORK R''� £•�� lJ/� � . BUiLpiNG SIZE��� � SQ.FOOTAG+E: .��, �HEIGHT,`.� �. " QBUI�DI�tCa $ .....�a;r.�:�_ ._;._,_�,�.= - ---� , . , , VAlUAT10N`'.aF`TOTAL'CQNSTRUGTION , �. , , , QEI.ECTRtCAL $ • AttitlP SERVICE � Q RROGRESS Et�fEF2GY [� W.R.E.C. . . �. QPI:UMBING � - � �,�!'"' , , ., , �( � ��- CR�nrt�c%HANlGA� $ �j O ' , ttALi,lATIQN,OE MECFtAN1CAl.[NSTA�LR'1'!OW -{ - � . . �� ��! � - , QGAS ,� ROQFiNG,,�O SFEGIA�t.I'Y �� OTHEF2 . FINISHED FLOOR ELEVATIONS C��� FLOOp ZONE AREA �YES. NO BUl1.DER COMP%►NY ' ` - , S1�3N�4TURE RE(31STERED Y/ N FEE CURREA: . :Y/.N .- Addre�s � ' License#"�� � ELECTRtC1AN, �, CClMPANY - . ' ` - - i SIGNATURE �' REGISTERED Y/ N F�GUR�n �Y/N' ': ' ' ` Address � + . , , . =.Ucense�#-=1 ' ` � � P�UMBER . , • ._, , COMPANY� , , , , _ _.. ..; ' SIGN�ITURE , REo�srEREu - :,.Y./-.N�:� � FEE.QURREt��= • `Y/�N: ;:' ' ���� � . �� . License# � " < _ � � MECHAirlIGAt: � . - � ,.COMP�N1!- L?`J�:. ,I,�'..�.!!�A n._.G G?1�S /y - . � SIGNATUR6 ^ ".'� .GC��.�; , REGI,�STERED: , -.Y:/'N:,� ,. E.CURREt� -.Y./-N`.. ' �ddrsss'", , il�{ `-�f'Il•v ` Z- ' `,f.` - ,. , :Llcense# �_A�. o y!,��1 ;f� .� � . � , , - i O;HER � . ' .. -� . , ; ., ' ,G{>�IiPANY - . � : , � � ,� i. , .__� -.. , � , . _ ' SIGNATURE.� :. " ` " „ ,REGISTEREO - . Y,/.�M:.e. �' 1;�GUF�� � ,Yd,N::-- , �,tfdeess . . Tx;���:tJ-�=r� ° , ., � `UcOnse#��� - t � � . . -_ ,.a�- yti�• �- - - -"�t•".,.d;'`+" 'h'�y<u�• ,a=.,;t:�t_ i..�t,tu., . . . . RESlD�41TIAL=._ -�A`ttacti;2i;#?lo�Plaits;,2;sets;of<But1d1'n':'�?lans,•,�f�;set:'of�Ene' �FaimS;;R=�O=W.Pemilf:forrietii+,.con`struc�on,- . , =.A { ) , . . . {.) , .. 9 , {.7.,. . �►Y...,. - ° ��. ..w;f -:,.-a :�. ;.x�Minimums,ten?(140.)�wQrktng;d,"ays;,atte�;'sutimlttali8ate:`=�Required,on"slte;�GonstrucUon?Plans;�Storinwater:Plans.w/Stlt Fence�insEalled, � ��San`ltary Fad4ltles 8��1�,dunX►pster SlteFWoifc�PerXnit:[or..stikidivlslorisltatge"proJect's�:.<-:��?�4 n'..' '�'.��.;:' � :. �� _- :; �. " COMMERCtAI. AKach(3j�eainpletie"sefs of'Butt�ing Pians pius a�t`�fef Safety Page;('1}set af Energ}r Forms.R 4W Perrr�it for.new ccn'structton. _ Minimum ten(1p)worlctng days after submittal,date. Requfred onslte,�CanstrucNan Plans,Stormwater Plans,wl Sllt Fence,lnstalled; . Sanitary Fac!litles�..1_dumpster..91fe..Woili Permtt fcr.�ll,new'proje�:All commerdat.requirements�must.meet comp!lance SI�N.PERNIIT Attacis{2)"s`efs of'�iigl',n,"_eereti=.Plat�s:.:�;:;?;:'.°`.°-r. • • , '"*"PROPERTY SURVEY:regulred..fqr�all NEW cans,truchon.. . , _" - , � �, Dtie`i6tlona: _ - . .r �- - . - - - -- • ' Ffll out apqNcaUon wmpletely. Owner&Canhacxor stgn bacic�of appllcaUon,natarized If'over S2S06,a;Nottce pf•.Commenc�mant ts required. (AIC upgrades over_37500)._, :. � " ,.,:•��:::.....:,w:::�==_. .,..,».._.... ........... .............�._._..�.. .. . . �. �.a..<...,._„ s - _ Agent.{for the contractb�).or'Po�`iiier of�Attoiney(fa�the�owne�)wbuld tie someone with nota�ized lekter from owner autho�izing same � .� •,. ,, F_, . _ . a_ DUER�THE:GOUN,T,ER.PERMI7TiNG=-'=::"`(FronE�of�A�ipticaUon Ontyj ' Reroafs If shingles Sewers Service Upgredes A/G Fences,(PIoUSurvey/Footage) -� - i Drivewrays-Not over Counter if�on pubila roadways.:needs ROW���F�� ' - . ,...,l'. , � � JG _ - ' �. _ ►TtCE OF DEED.:RESTRICTiONS: The;underslgnedz.Under�tan,ds��t�at:th(�:;p�rmit;may,.be..subJectLLto.,"deed"rest[lctions"��`_ ' "-_ .�.. , �t <�—, ,�,,..c:.a ..S.._,� - ,�.r-...., �:U' ich may be�more�rest�icttiie=tF»�=Gounty reg�ilatforis:7he-.U'n'derslgned'°a�°sr�me's:resp�nsitilltty`fo�`compliance�witli<any��� �� , _. .. ... . .. . ,: . .. . �Iicable'�deedsrestrictlons:. � ,._ � , .:- _�.:;�: ,;._.: _ •_ � - _ - - . - . ° ,_. .,_ ,. . ;,.- � ,.,,,:;,,� , •,��� ,-; .�;°: .; ��. ,...,;....,....:.::.....::�. ,:r,,.�,• .a.,.:> - - a.�.�, ! , -' tr7.;:,�:.<•':; ILICEN$ED��CO,NTRAC'FORS==AND'CONTRACTOR RESPO�i�;fl�Il�ITl�S':: ��l����heFowne��°�Has`fiired�"a�"`c�ritractor or �tractors to undertake>wo�k;.tfte =me ;�6eF.r.. �'I�d:AtqrGe;licensedYin�:accordance�v�ith�state;;and:�[o�:al;regulatlons:��;�=1f�tfie����r'•�� . � "sed�as�<re�ulred"ti':,lativ?botli'-ttie;`oumer�and=��conVaetor�ma�'�tie�clted�for`a�kmisd,erneeno� violatlon , �tractor�:ls:not�,lice'n q , y , , Y ier state ladv. If the owneror Intended��co',n.tra�to,r�a�e,�wunce�in,as.to_wt�at'licensing..requlrements;may��`apply°;1fo�:tli�?-��{�;°�:-J��• - mded work,�they�are��dvlsed'to:contac�'tFie Pasco County Bullding.IriBpectlon DIvlslon;�-Llcenstng Sectlon at 727-847- . )9. Furtherriiore,�=ff��the ovvner�has"hl�d a�coritr`acto� o� contractor�, �i� is advised to have�the contractor(s).�sign,.,,,,_. ,,,�, ,; ilons of the "contractor Block"..of`tfils_application.for,which_they...wlll.:be:.�esponsl6le..:-lf:you;.=:as:..the`owiier'.;slgn as�tfie�' "'� ` i>. itractor;,tiiet'�rnay 6e�an lndication-that��he��s.not.properiy Iicensetl�and 1s�nof�enUtled`to�pemiit�tng p�tvlleges=tn Pasco -f �;� •, .�.,. � �.. „ , � .. ; :��c::�,•,,e.=: <:::�.;�_. unty. . � . _. _ . , , . .. - ..�.,.._ ._ .-;- .. _ . .. .. . � --.,.._... �_. ::_. ..:_ ANSPORTATION:IMPACTNTILI*IES%I�YIPACa'�=AI�b>ItESOU�CE RECOVERY�FEES:�The�nnderstgned�understands ':.. . � . ,.... •. . tT�ansponation Impact Fees:and.Recouree Recove.ry.Fees may:�epply�:ta.the conatcuctton.of_new,buqdings;:;change�of',��`��`���='=� �', � � in existing buildings;:�a�r'�expa�istbn�.of=�iils�'�briiltlings��a§�specffted.in P�sca CounEy Ordinance number 89-07 and , 07, as amende,d.,:,The undersigned �Iso::understands� tng��such fees�-;as r�ma�^�e�-due'�;,�vill:�e identtfied at the=time��df='`����'� � = - mitting. It is turt�ie�underetood'that_'Tra��portatlon`:Impacf'Fees and�Reaour.ce',Recovery�Fees�,:mu�ti be paid prior to eEving a"cer#Hicate��of<occupancy"��or•flnat�.powec�,release. -:If`the.proJ�ct;does;not-lnvolve:a:�.certiflcate of occupancy.o�,'>>�''���'��� � ; il power�.release;.the��fees'-:iriu�t�•�be'paid'-pcio."rto.permit issu�nce. :Fu�ther:more;:�ff�Pascm,�Coanty�Water/Sewer-,impact�-� ., =_.��• . ; s are due,:they must be;pald prior to:permit�-lss4ance;'�n:accordance:wif�:applfcatite�Pasco County ofdinances. �N�TRUCTION'1`IEN`LA1AI�(Chapter'713�Florfda Statute���emended): �f;valuatlon of work is�$�;500:OO,or�mor.e;I�• ��� ;�-�= , __.. . ., � tify that I, -.�he.appltcant,,:have_:been��pravided:�with-.a �copy_:of,.the��,'Florida���Constructlon.�L"ten_:L-av�Homeowne�s �tection Guide" prepared by.,tF�e Flo�ida'DepartmenC of Agric.ulture and Consumec�Aifairs. If the appllcant is someone: ;;, . .;;�_-�_: � a .....�,�,_ . er than the°owner"� I cectifjc.that:I;ha.v.e.obtailned'a`'copy;of the�abQya;des,cripetl;�bcu�ent�and;p.r.o�i.se�_In;good:.faith;to., __ _ Iver It to�lher...•.owner��,prio�:to�commencemerit:'' `. . .''`" � , . -- � � � • '. - , �NTRACTOR'SIOWNER'S AFFIDAVIT: t.ce'r:t,lty.�tkiak al{:�th�:Inf.ormatlon�In�.tMl.s�appllcatlon is accurat�:�nd that alf viiork 'be done in compllance�wlth.all.appllcabfe'laws regulatlng constrvction� zoning and�land;development. Appltcatlon (s eby made to obtain�.a.permtt.,�to;,,do.rwotk�.._and�'liistallaflon as Indtcafed:�,,.�1; c�niiy"�that no`work��or- Installatton`has ' - nmenced`prlor to`Issuance of a permlCYand that':all'work wlll be performed�to meet-:stand�rrds_of all laws regulating• istructlon, County and Cily codes, zoning regulattans� and land development�cegulatlons�ln'the�:jurlsdtctlon.� -1 �also - : � tlfy that I u�derstand that the regulattons of other�govemment agencles may�apply�to,.the4lntended:work� and that it is __ , responslbllity to Identlfy•what,acttons.l_.must.take:b bedn:.corr�pllance..Su�h�agencles=lnclude but-are.:not Iimlted�:to: . - Depa�tment.of E�lvlronmental:'Protectibn=G�Pi+ess"Bayiiead�;'V�IeNand%Areas and Envlronmentally Sensltive Lands�WateNWastewater Treatment. ". � � � - - Southwest Florlda Water Managemen�-�...:l�tsfrlct Wells, ��Cypress.s'.Bay�`e�ads; Wetland Areas, Altering ' � W�tercourses. , � � ' ; ' - Army Corps of EnglneeFs-Seawall§; Docks, NavlBatile Waterways. , , - Department_of;Health�:8 ReMabllltative.SenitceslEnvironmen#al,;Health�Unit:Wells;�-Wastewater�Treatment, Se�tic Tanks. , , � � _ - US Envlronmentel Protectlon Agency-Asbestos abatement. - Federal Avlatton�AWMority,.;Ruraways: � , �derstand that the:folloviring;cestrlctlons:apply to'tfie t�se of flll:• - Use of�II Is not allowed iri Flood;Zone"V"unless expressly permltted. - If the flll:materlal_ts_�to`��be;::used:=ln�•f.lood::Zone. �A",�It 1s understood�that�a drafnage�plan addresstng a "compeFlsating volume"wlll be submltted at�lme of per►nlfting wf�lch ls prepared by a professtonal englneer ' Ilcensed by��he�`�tate�of�Flotlda:.. . � .. - If th�..flll:mate�1af�=t�-:to::tie-,used�In �lood Zone 'A" Itr�connectlon•wlth:���permitted buflding using stem wall � construction, I:certify;that_flll:wall.l�e��sed,only.to:i111the.areawlthln:the�stem:�watl.. . - - - � If flll�"mate�laf ls��-to-�be�=used�1n any area,=1'��certify that .use. of such'"flll wlll not�adversely affect adjac:ent propertles. If.use�of flll is found�to edvereeEy,.<�ffect�'adJaEerat��prctperties,.the owner may be clted far yiolating � the condWo�is�of'tFie"ti�iilaing:�p�rmit lssued:under thst attactied„permit:�ppl(catlo�� for�:lots less:�than.one (1) acre�whlch�ere elevatetl'6y�illl��rr er�gtneered dralnage plan"ls requlred. • . •� am the AGEN.T..FOR,,THE�O.WNER,,`I�romise'In.good falth to�Inform theYowner�:of�tfie:permltting.condltlons:set forth In ;�; .�. aifidavlt p�lor'to comm�nclrig��consttucEltin.��'1'un;derstand tfiet a�eep�rate permlt may be requtred for elect�lcal work�. -_ ���.; ',�; nbing, signs� welts,.:pools,zalr..condltloning�.,:gas,;.or.otfier.'1n8t��tlons nokspec�tically 1ncluded�tn:the�appllcallon, �A� - „ '�t;, ;.i nit Issued sfiall"be�conshued to`be:�a°�Ilcense:to��proceed vulth`the'work�and nok�as::authoNty to vfolate,�cancel, alter, or , '� astde any provlstons;of the:tecfinlcal:codeg;�nor shall Issuance�of�a.permtt.prev�nt tFie Bulldlrig,0#ficlalfrom therea`fter , �>�� Y, �Iring a correction;.af'erro[s��tn:plans:;'ca�nstFuctlon,or vlolatlons�of-any°codes: ��vsry.p�slmlt•Is'sued�shall�becume invalid � iss the wo�k�author`tzed;tiy sucti permlf�is.commenced�wltiifn sUc,months�of�permft Issuance� or IF work authorfzed by '=' pemnit is suspended.or..abar�doned.fo�.a:�vrlod;of;s�c:�f8):montTis;.aRe�the.tlme�the�work��ls commenced. An extenslon , ► be requested� In writing;:f�om�the'"BuIlding:�Elal:for�a pe�lod:�not�to.exc;eed,��nlnety�{90)��days-a�d�wllf demonstrate �='� � fiable cause�for.�the e�tenslon� If�work ceases,for ntnety(90)con`s.ecutive:d�y.s�..th�)ob_Is�consldered abaadoned. :� �, RNING T0`OWN�a:° YQUR.,FAILWRE TC1:�R�EC.Ott�;l4:NOTI.GE;OF�,-COMMENCEMEMT::Nt�1Y:RE$ULT�IN�YOUR .- ,* ��; 'IIVG TWIC,E;FOR�IMPROVEMEN�'��TO:�YOUR::PROPEF�TY:�:I�-:YO.UxIA4'�EKID"TO;?�i9TA1N4FIN�ANEING;��ONSULT �, U - D� `O A� TTO R , � �:; ,p � t� . . - ,__ __ m� _ tIDAJURA�(F.&.11.7. --- ------ ---�.._ ,.-:: ��---• -- -,,,.�u . , . __ _,_ - --�— - IER OR AOENT l C�MTRItCTO • �—�� � I atbed and swom (or a ed)be e s' Sutiecrltied'end'swom-b r'afRrmed)�before me ttilg .. . bY , y _ ,., : Is/are personally knovm to.me or�haslhave produced Who:ls/are ersonally owm�to me,or,haslhave prodnced • �i aerlden6flcaUon.- - � -" ,as Idendfica0on. � Notary Publlc . � Notary Publlc nlsslon No:' ` Comr�l .IJo. �;�A::'^"'� JACQUEL E BOGES a• • ;,� ::: Commission . • . �;y :�; Ex ires Deceml�er 12,2018 - �of Notary lyped,printed ar stemped Name of Notery typed,�dnt �;' _htafi��h^!Troy Fa::!;:zuzn:e 800385- .� II I �� � �� PROPANE GAS Service Order/Pronos�l � � � � AN� Af�. INC. +- Air Conditioning 8 Heating �i��e �988 813-782-5013 ���� o� � " �� — �� • , ,�, .�-� - =-I�. -- �, � : - �� ,•l�:1Ft,, ir71.�F:1t1:• _.k_F�' I, _� i;- . �.:�: , `:� . . ._t. ,l,l,�-T, c' , , 'j�,IF; i t�1 i. . 4�C., � � t._• `-s :� PROPANE GAS 4� i!i i i : � , i i , :=_'•-- ' ' `,'i�1' � �.. AlC iNc. n. "i F:, r n i �C? =; r _ - �_,�... !� �%��:;; �'i AND i_ � ( 1.__ M:-'i" �• �I__i:� r-, _ •r'�',. L. l"-_, i i_Ir'ii_. F-':i='.: L I._�{ ;.., i � rif�' ,.'I;'+,,�rtF:, ' �'1-ICJi�i1:-.k: = - , - - :,�..��:; � - - ._ . f, - - ':�_I�_� ��_. -r�'1�t . _. . f'� : � 1 I_ i .I 1"il Iltli_�r i_ll'i. ."li'"�i'�li�',1 ' �: �i_ . __. I � l_j'•��'JI_ii�L �-'I . 'j:� � ; if_i�G�_ �' , . :� .._�. . i i � �"i i: 1_.1....', � . . • • • • iyi�jF.�l`.j::.l �� Ia� `'''ij rl,i,'.�� •r'.� __ i:��=�'i-' . � , �c:- i _.���F 4:�C:G:� 'i: :1'�i4::i�:.:-� _ � ._ --� ti� r r � � s..t)�.�,- e ,�i�$ --_-. ! _ .`�_.�.r , �..��'i ;:k�: i';i:i;-�'--- .. ��hlri�, • ,�,�_`'T i_' 'r I ' •' � r` " ' `.,;; 1 T. �_�__�),. •F=f�f_-:�7i.1. � i� �7i_�i._�: _�i' � _� !_: C , i,c�: J �. � i� � _�; . L 1 :(-i f I �� ! 1��r•7 _l:. � � - DESCRIPTION�OF'WORK •. � � -'� QTY: MATERIACS�8�SERVICES.. ' . � � �� VNIT PRIGE AMOUNT _. ._ .._.._._..... ...__ ....__........... . - i i :��. ('�. � �F-� ��+��� �_a -,�-„-j Y'.•_< ;�, � � `'`\- i i - t� � 4 �' �'n . �� �l �" � � ,'�v-� � � � � � _�" � I ��� ;r.Q(�� ' c' JQ , lJ� ..,�i'f�; ��' �'� T:�� ��, '� - �-E'?- i . �-� �1�, F� . -�-� C � '� e.c . � � v . � � 3 � i i /• f " ._.. _;�.--.T. . i � � ��� ,-� ,-,- �...� i � :1�.,�;.�- �����. SL' , � � � -- � � � � , � � � � - :.,RECOMMENDAT(ONS ` � � - � � - i i � 4nnual'�Maintenance Recommended by AII,Equipment Manufacturers. � � . Pressures Lo HI � T-Stat i i i i , REFRIGERANT R- LBS. " $per ltis. � I , ' FILTERS x z Changed Monthly I I • . � ' � FILTERS x x Changed Monlhly � ,o, ' � ❑�REGULAR ❑WARRANTY TOTAL SUMMARY ' Defiumidistat Settings: When here"ON", When Away§0°(g,.T-Stat 80°� ❑ MAINTENANCE CONTRACT SERVICE i .IMITED WARRANTY: AII materials,paris and equipment are warranted by the manufacturers' ' METHOD.OF 1PAYMENT ' CALL � i r suppliers'written warranty only.All labor performed by the above named company is warranted for - TOTAL i '� O days or as otherv✓ise indicated in writing.The above named company makes no other warranties, ❑CASH ❑CK# MATERIALS i xpress or implied,and its agents or lechnicians are not authorized to make any such warranties on ehalf of above named company. 0 DEBIT ❑CREDIT ❑OTHER MAINTENANCE � nave authoriry to order the work outlined above which has been satisfacronly completed.I agree Ihat Seller PROG. W 1 C � :tains title lo equipmenUmalenals furnished until final paymenl is made.If payment is not matle as agreed, CLAIM# .Lt i eller can remove said equipmenUmaterials at Seller's expense.Any damage resultinq from said removal shall +4 � �Y'i ot be Ihe responsibiiity of Seller.NET 30 DAYS.A 1 1I2%SERVICE CHARGE WILL BE ADDED MONTHLY 70 � 1L UNPAID BALANCES OVER 30 DAYS.NO REFUNDS DATE COMPLETED / � TECH. T�� � � _ i I G/—,�,,�,,,/ ��J/�, i USTOMERSIGNATURE DATE ✓1E�A//NL ✓(f�u TOTAL �