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Home My WebLink About16-16901 CI�I( OF ZEPHYRFiiLLS � = 5335-8TH STREET (813)780-0020 16901 BUILDING PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 16901 Address: 4801 AIRPORT RD #102 Permit Type: MECHANICAL ZEPHYRHILLS, FL. Class of Work: A/C CHANGEOUT Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): � Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 13-26-21-0130-00100-1020 Improv. Cost: 7,450.00 OWNER INFORMATION Date Issued: 1/15/2016 Name: HUDSON JOHN E & JUDITH A Total Fees: 75.00 Address: 4801 AIRPORT RD APT 102 Amount Paid: 75.00 ZEPHYRHILLS FL 33542-5284 Date Paid: 1/15/2016 Phone: 585-259-3109 Work Desc: A/C CHANGE OUT 2 TON CONTRACTOR S � APPLICATION FEES '� US AIR CONDITIONING & HEATING A/C CHANGEOUT 75.00 i r`n � ` � Ins ections Re uired DUCTSINST LLED j DUCTSINSU E FINAL � ' ,L,_�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 properly 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 I before recording your notice of commencement." ' Complete Plans,Specifications Must Accompany Application. All work shall be pertormed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. � � ' CONTRACTOR SIGNATURE � PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813-780-0020 City of Zephyrhilis Permit Application Fax-813-780-0021 p, � Building Department Date Recelved � Phone Cantact for Permitting -rr i rr r�-r� - --'rrr-�� Owner's Name u Owner Phone Number 57��/-� Owner's Address OO •� �T � � Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS LOT# � SUBDIVISION �� k r• . 1. PARCEL ID# ��'G7��14r l�� O Ob+ O � (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED � NEW CONSTR e ADD/ALT � SIGN Q Q DEMQLISH INSTALL REPAIR PROPOSED USE Q SFR Q COMM � OTHER TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q DESCRIPTION OF WORK {rI� S S BUILpING SIZE SQ FOOTAGE HEIGHT � TTRRTTTrTTTrITTTTTrr�TTTTkT•r'r'rITTTTrrTrTTTTr QBUILDING g � VALUATION OF TOTAL CONSTRUCTION Q ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY � W.R.E.C. �PLUMBING $ �a` �MECHANICAL $ �ysa�aa VALUATION OF MECHANICAL INSTALLATION �( •v �GAS Q ROOFING Q SPECIALTY � OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO BUILDER COMPANY SIGNATURE REGISTERED Y/ N ,FEE�CURRE� Y/N ' Address License# ELECTRICIAN COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N � Address License# PLUMBER COMPANY SIGNATURE REGISTERED �Y 1 N � FEE CURREA � Y/N Address License# MECHANI COMPANY {1� � � � SIGNA E REGISTERED Y N � FEE CURREI. Y I Address License# OTHER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y J N Address License# I f l I 1 11 I 1 1 11 1 1 E I 11 L I � 1 1 11 I I t l 11 ! I l 1 1 1 1 11 F 1 [1 [ I [ 1 1 l l i l F 1 11 [1 1 11 1 1 11 [ RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(t)set of Energy Fortns;R-O-W Permit for new construction, Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence instalied, Sanitary Facilities&1 dumpster;Site Work Permit for.subdivisions/large proJects COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Fortns.R-O-W Permit for new co�slruction. Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, Sanilary Facilities 8 1 dumpster Site Work Permit for all new projects.All commercial requirements must meat comptiance SIGN PERMIT Attach(2)se�s of Engineered Plans. •"`PROPERTY SURVEY required for all NEW construction. �i-F{-i�I-�FFi�4�i-4-F�M�FI�L-t-.FI�FHf+�FhL-i-f-i�[+6�FF-E�6-f-f-i+«FFF4-Fi-i-d+i+H-•L�i-F�FI�FLi�I-i-FI-N�F Dlrectlons: Fill out application comptetely. Owner&Contractor sign back of application,natarized If over SZ500,a Notice of Commencement is required. (AIC upgrades over$7500) " Agent(for the contractor)or Power of Attomey(for the owner)woutd be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITfING (copy of contract required) Reroots if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) Driveways-Not over Counter if on pubiic roadways..needs ROW j � 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 Division—Licensing Section at 727-847- 8009. Furthermore, if the owner has hired a contraptor or contractors, he is advised to have the contractor(s) sign portions of the"contractor Block"of this appiication 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�involve a certificate of occupancy or final power release,the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer 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 certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's Protection Guide"prepared by the Florida Department of Agriculture and Consume�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'SIOWNER'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 hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation 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 government 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 I Lands,Water/Wastewater Treatment. - Southwest Florida Water Management District-Wells, Cypress Bi yheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalls,Docks,Navigable Waterways. � - Department of Health & 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 fill 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 Iicensed by the State of Florida. - If the fill material is to be used in Flood Zone "A" in connection with a permitted building 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 fll will not adversely affect adjacent properties. If use of fill 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. i 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 specifcally 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 tFie 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,t�he job is considered abandoned. ' WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMEN T MAY R T IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEN O OBTAIN F C G,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YO E� NCEM FLORIDA JURAT(F.S.117.03) � �� i � . OWNER OR AGENT___ CONTRA T Subscribed and swom to(or affirmed)before me this Subscribed an arn o( r a med be e th' � by by Who is/are personally known to me or has/have produced Who is/are personally kno to me or has/have roduced as idenlification. as i tification. v . _ Notary Public _ ry Public ° .��:-JOE E.BACON Commission No._ _ Commi ion � . _ '��__ _�� ' = Expires June 29,2018 ,, a. Name of Notary typed,printed or stamped N e No t{�di�e��p�dy Fein tnsuranee eoo�gs-7ota � - - �a�o�_� ��o� 0�:9� R_M. E N T E�-PR 1�E S - - - _ - � coa: r. n�:, co.,w�io,: _ I - L''"'! �'• ' � ' r aF2UttlECT - t��Y- - i�la_:-.v.. �r-r rr�i i�� C'T f�n P C' ' ' a �►3�- ��`—= 1 1C LJUv�IY_ J 1 f\n J - __ 1 r-t� B6�7oJ-15� �Qz (86�)70�-_21? - - _ - _ . _ _- _ _ L -�- .� t0� SW 1�1h SV=eI — Sv�La :i _ _ - --�-- � 1"� 1 `` OGeecnc3ca_ flo(tda JC9�i - - -- � �- � .� - • - '- - `` _ �� .�• . • ' 3/�6-N- l % � , ' 1� �i _ �: , . - � /d^ �. _ � _ - � fC Ut�I7 = 3i:'� 3�8� m � _ - . 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Sc...— 9•:.� �=•_ I ' � , 1 1 NOTE & DISCL4SURE STATEMENT (Including Arbitration Clausej Principal Amount of Loan: Date Note Sent to BoRower: Estimated Oate of Loan: Loan Number. $7,500.00 January 13,2016 January Z0,2016 2340199006 Name 8�Address of Lender: Name 8 Instaliation Address of BoRower(s): Judith A Hudson EnerBank USA John E Hudson 1245 Brickyard Road,Suite 600 4801 Afrport Rd 102 Salt Lake City, UT 84106 Zephyrhills,F�33542 In this Note&Disclosure Statement(this"Note"),the words"I","my", "me","we"and"debto�'refer to Borrower(s)identified above;and, the words"you"and"your"refer to Lender identified above or,upon assignment of this Note,Lender's assignee. 1. Loan. 1 have applied to you for the Eoan evidenced by this Note to purchase certain goods, equipment and/or services from US Air Conditioning,Heating(Refrigj ("Contractor"j. In order to induce you to make this loan, I represent and warcant that I will use the loan proceeds only for the purpose stated and only for the home improvement project at the address (the "Installation Address")set forth above. I further represent that 1 either own the pYoperty at the Installation Address or reside at the Installation Address which is owned by the co-Borrower under this Note. By signing the Payment Authorization Form bearing the same Loan Number referenced at the top of this Note, I am agreeing to the terms and conditions of this Note and I am acknowledging that the goods, equipment and/or services purchased from Contractor are acceptable and, if applicable, have been installed to my satisfaction. Furthermore, by signing the Payment Authorization Form, I am instructing you to disburse the proceeds,of the loan to Contractor. THE PAYMENT AUTHORIZATION FORM MUST BE SIGNED BY BORROWER(S)AND CONTRACTOR. IF THE SIGNED PAYMENT AUTHORIZATION FORM IS NOT RECEIVED BY LEIVDER ON OR BEFORE 05/11/'16 , THE PAYMENT AUTHORIZATION FORM WILL BE VOID AND THIS NOTE WlLL HAVE NO FORCE AND EFFECT. 2. Promise to Pav. By signing the Payment Authorization Form, I, Borrawer, promise to pay U.S. $ 7,500.00 (the "Principal"),plus interest,to your order according to the payment schedule below. 3. Interest. Beginning on the date the loan proceeds are disbursed by Lender to Contractor and conGnuing until the amount I owe you has been paid in full, I will pay interest at the simple interest rate of 2.99 % per annum. This interest rate is the rate I will pay both before and after any default described in paragraph 7 of this Note. Interest will accrue daily on that part of the Principal which has not been paid. Truth in Lending Disclosure Statement ANNUAL FINANCE Amount Financed Total of Payments PERCENTAGE CHARGE RATE The amount of credit provided The amount I will have paid after The dollar am�unt the credit to me or on my behalf. I have made all scheduled The cost of my credit as a `^'��cost me. payments. yearly rate. 2.99 % � 1.186.80 (e) $ 7.800.00 $ 8,686.80 (e) � Payment Schedule: My payment schedule will be: � Number of Pay,ments Amount of Payments When Payments are Due 120 $72.39 30 days after the loan proceeds are disbursed to Contractor and on the same day of each_month thereafter Prepayment: If I pay off this loan early, I will not have to pay a penalty. Late Charges: If a payment is not made within 10 days of the date it is due, I will be charged a late charge of$30 or in an amount equal to 5%of the unpaid amount of the payment,whichever is greater. Other Terms: I should read the remainder of this Note for additional information on nonpayment, default and your right to require repayment in full before the scheduled maturity date. e means an estimate Itemization of Amount Financed Amount paid to Contractor on my behalf: $ 7,500.00 Total Amount Financed: $ 7,500.00 4. Pavments. The payment schedule above assumes that I will pay all amounts when due. My first payment due date will be printed on my coupon book which you will mail to me. My monthly payments will be applied in the following order if I am not in default: interest, principal and other non-default fees and charges. If! have paid late or have been otherwise in default, my monthly payments may be applied in a different ord@r at your discretion. Because interest accrues daily on the unpaid principal balance,the amount of the last payment may decrease or increase if I pay earty or late. If, on the final scheduled payment date (the "Maturity Date"), I still owe amounts under this Note, I will pay those amounts in full on the Maturity Date. I will make my monthly payments to you at such location as you shall designate. 1-2000-1 Rev 316115 . . , � � I 5. Riaht.To Prenav. I may make a full prepayment or a partial prepayment at any time without paying any penalty. Notwithstanding the foregoing, I understand that if I prepay more than 3 monthly payments, but do not pay my loan in full, my next payment due date will be moved forward a maximum of 3 months, and my regular monthly payments will recommence monthly thereafter. 6. Other Charaes. If you have not received the full amount of my monthly payment within 10 days of the date it is due, I will pay you a late charge of$30 or in an amount equal to 5% of the unpaid amount of the payment, whichever is greater. I will pay this late charge only once on any late payment. Additionally, I shall pay you a fee of$30 for any check or any other form of payment I give you that is dishonored or retumed to you unpaid. Any overpayment in excess of$1.00 shall be refunded at final payoff of the loan. 7. Default. I will be in default if any one or more of the following should occur:any payment or any other sum is not paid when due; receivership or insolvency proceedings or any assignment for the benefit of creditors shall be instituted by or against me; I die;or, I fail to keep any promise or meet any other obligation in this Note. 8. Your Remedies Uaon Default. If this Note is in default,foflawing any notices required by law,you may require that my unpaid balance, including interest and other charges and fees due under this Note (and not just amounts in defaultj, be paid immediately. If this Note is in default and you are not immediately paid all amounts due under this Note, you may: set off my liability on this Note against any of my deposits or property you hold;or pursue any other remedy you have under applicable law and following any notice to me required by applicable law. I will pay all collection costs and expenses, including your actual and reasonable costs of enforcement and collection of any amount due and payable under this Note, to the extent permitted by law. Such collection costs and expensss shall also include reasonable attorneys'fees to the extent permitted by appllcable law, including any and all such fees arising due ta a bankruptcy filing by or against me. 9. Obliqations of Persons Under This Note. If more than one person signs the Payment Authorization Fonn as Borcower, each such person shall be fully and personally obligated to keep all promises in this Note, including the promise to pay the full amount owed. You may enforce your rights under this Note against each such person individually or against all Borrowers together. This means that any one of the Borrowers may be required to pay all of the amounts owed under this Note. You may give one Borrower extensions to pay or change or release his or her responsibility without releasing any co-Borrower in the same way. 10. Time Is of the Essence. Time is of the essence. This means that all required payments must be made on the day due and all other obligations must be performed on time. If I require additional time to make a payment or perform any other obligation, I understand that I must obtain your approval in writing in advance far making a late payment or rendering any other late performance, and that you are not required to give such approval. 11. Invalid Provision. If any provision of this Note cannot be enforced,the rest of this Note will stay in effect. 12. Waivers. You may delay enforcing any of your rights or elect not to enforce your rights without losing any of them. I and any other person who has obligations under this Note waive the rights of presentment and notice of dishonor. "PresentmenY' means the right to require you to demand payment of amounts due. "Notice of dishonor" means the right to require you to give notice that amounts due have not been paid. 13. Governinq Law. This Note, and any claim, dispute or controversy arising out of or relating to this Note or my loan, whether based on contract, tort, fraud and other intentional torts, statute, regulation, constitution, common law and/or equity, are govemed by and construed in accordance with the laws of the State of Utah (without regard to intemal principles of conflicts of law)and applicable Federal law. The legality,enforceability and interpretation of this Note and the amounts contracted for,charged and received under this Note will be govemed by such laws. This Note is entered into by Lender and Borrower in Utah. Lender makes decisions about granting credit to Borrower and extending credit to Borrower under this Note from Utah. Lender and Borrower irrevocably and unconditionally agree and consent that any arbitraGon, proceeding relating to or arising out of this Note(or,to the extent applicable,any suit, action or other proceeding relating to or arising out of this Note}shall be brought exclusively in an arbitration tribunal (or state or federal court or other tribunal), sitting in the State of Utah, Salt Lake County. Lender and Borrower hereby irrevocably waive, to the fullest extent permitted by law,any objection to such venue and further waive any claim that such venue is in an inconvenient forum. In the event of any conflict between the foregaing choice of goveming law and venue provisions and the rules of the National Arbitration Forum,J.A.M,S./Endispute,or the American Arbitration Association,then these goveming law and venue provisions shall control. 14. Neaative Credit Reports. As required by Utah law, I am hereby notified that a negative credit report may be submitted to a credit reporting agency if I fail to fulfill any of the terms of my credit obligation. 15. Entire Aqreement. This Note is the final expression of the agreement between Borrower and Lender and may not be contradicted by evidence of any oral agreement or statement. 16. Assianment. Lender may assign this Note and may do so without my permission. I may not assign my obligations under this Note. 17. Credit Report Authorization. Any person individually liable pursuant to this Note authorizes you or any of your affiliates fo obtain credit bureau reports regarding such person's personal credit and make other credit inquiries that Lender determines are necessary. 18. Contractor Not an Aqent. I understand and acknowledge that Contractor is not an agent of Lender, that Contractor has no authority to act on behalf of Lender,and that Lender is not bound by anything the Contractbr does or says with respect to this Note. If I have authorized Lender to have Contractor deliver this Note to me, I acknowledge that Contractor is doing so only as a courier and for my convenience. I also understand and acknowledge that Lencler, not Contractor, has prepared this Note and that any questions I have regarding the Note or loan process should be directed to Lender. Notice for California Residents; California law requires that Lender inform castomers that should they fail to fulfill the terms of their credit obligation, a negative report reflecting on their credit record may be submitted to a credit reporting agency. If Borrower is marcied, Borrower may apply for credit in Borrower's own name. , Notice for Florida Residents: Borrower agrees that, should Lender obtain a judgment against Borrower, a portion of Borrower's disposable eamings may be attached or gamished (paid to Lender by Borrower's emp(oyer), as provided by Florida and Federal law. �-zooa� Rev.3/6/15 . a • Notice for Maine Residents: Lender may request a consumer report in connection with Borrowers application for credit. Borrower may ask whether a consumer report was obtained by Lender and Lender wil{ tell Borrower the neme and address of the consumer reporting agency,if a report was obtained. Notice for New York Residents: Consumer reports may be requested in connection with the processing of the application and any resulting Note. Upon Borrower's request, Lender will tell Borrower whether or not a consumer report was requested and the names ' and addresses of any consumer reporting agencies that have provided Lender with such reports. Notice for Ohio Residents: The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy consumers and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio II Civil Rights Commission administers compliance with this law. Notice for Vermont Residents: A consumer credit report may be requested in connection with this application or.in connection � with updates, renewals or extensions of any credit granted as a result of this application. Upon Borrower s request, Borrower will be ', informed whether or not such a report was requested and,if so,the name and address of the agency that fumished the report. I Notice for Wisconsin Reside�ts: Wisconsin law provides that no provision of any marital property agreement, unilateral statement, or court decree applying to marital property will adversely affect a creditors interests unless the creditor, prior to the time credit is granted, is fumished witfi a copy of the agreement, statement, or decree, or has actual knowledge of the adverse provision when the obligation to the creditor is incurred. ARBITRATION: All disputes, claims, or conUoversies arising from or relating to this Note or the relationships which result from this Note and/or any guaranty of this Note, or the validity of this arbitration clause or the entire Agreement, shall, at the election of either party, be resolved by binding arbitration by one arbitrator selected by me with your consent,or appointed by a court if I fail to select an arbitrator or we cannot agree upon an arbitrator. Any arbitration under this provision shall be conducted according to the rules of either the National Arbitration Forum, J.A.M.S./Endispute, or the American Arbitration Association. I have the right to select which of these arbitration forums to use; but if I do not make a timely selection, you may choose one. This arbitration agreement is made pursuant to a transaction in interstate commerce, and shall be govemed by the Federal Arbitration Act at 9 U.S.C. Section 1, et seq. Judgment upon the award rendered may be entered in any court having jurisdiction. The parties agree and understand that they choose arbitration instead of litigation to resolve disputes. The parties understand that they have a right or opportuniry to litigate disputes through a court, but that they prefer to resolve their disputes through arbitration, except as provided herein. THE PARTIES VOLUMTARILY AND KNOWINGLY WAIVE ANY RIGHT THEY HAVE TO A JURY TRIAL EITHER PURSUANT TO ARBITRATION UNDER THIS CLAUSE OR PURSUANT TO A COURT AGTION BY YOU (AS PROVIDED HEREIN). The parties agree and understand that all disputes arising under case law, statutory law, and all other laws including, but not limited to, all contract, tort, and property disputes, will be subject to binding arbitraGon in accord with this Note. The parties agree and understand that the arbitrator shall have all powers provided by the law and this Note. These powers shall include all legal and equitable remedies,including,but not limited to, money damages,declaratory relief, and injunctive relief. The institution and maintenance of any action for judicial relief in a court to obtain a monetary judgment or to enforce this Note, shall not constitute a waiver of the right of any party to compel arbitration re ardin an dis ute or remed sub'ect to arbitration in this Note. ANY HOLDER OF THI5 COIVSUMER CREDIT CONTRACT IS SUBJECT TO ALL CLAlMS AIdD DEFENSES WHICH THE DEBTOR COULD ASSERT AGAINST THE SELLER OF GOODS OR SERVICES OBTAINED WITH THE PROCEEDS HEREOF. RECOVERY HEREUNDER BY THE DEBTOR SHALL NOT EXCEED AMOUNTS PAID BY THE DEBTOR HEREUNDER. BY SIGNING THE PAYMENT AUTHORIZATION FORM BEARING THE SAME LOAN NUMBER REFERENCED AT THE TOP OF THIS NOTE, ItWE, THE ABOVE-NAMED BORROWER(S), ACKNOWLEDGE 7HAT INVE HAVE READ AND UNDERSTAND ALL TERMS AND CONDITIONS OF THIS NOTE � DISCLOSURE STATEMENT, INCLUDING THE ARBITRATION CLAUSE, AND INVE ACKNOWLEDGE RECEIPT OF A COMPLETELY FILLED-IN COPY OF THIS NOTE. INVE FURTHER ACKNOWLEDGE THAT 7HE LOAN PROCEEDS WILL BE USED ONLY AS SET FORTH 1N SECTION 1 ABOVE. SlGN THE PAYMENT AUTHORIZATlON FORM AFTER PRQJECT IS SATISFACTORILY COMPLETED. 1-2000-7 Rev.3l6l15 ., . • : � �� r� . PAYMENT A THORIZATIC)N FORM I� U LOAN AMOUNT: �7�rjQQ.QQ LOAN NUMBER:2340199006 DATE: January 13,2016 NOT VALID AFfER:May 11,2016 BY SIGNING BELOW, INVE [THE BORROWER(S)]: , 1. Acknowledge receipt of the Note & Disclosure Statement (the "Note") bearing the same loan number referenced at the top of this form for my loan with EnerBank USA and agree to be legally bound by the terms and conditions of the Note. 2. Confirm that there has been satisfactory delivery of all equipment, goods and/or services by the Contractor, and if any installation was included in the contract, there has been satisfactory completion of such installation. 3. Represent and warrant that the loan proceeds will be used only as set forth in the Note. 4. Instruct EnerBank USA to disburse to Contractor the proceeds of this loan in the amount of • ' Seven Thousand Five Hundred Dollars &Zero Cents. Borrower Date Judfth A Hudson Borrower Date AUTH�RIZATION NUMBER: 13355911 John E Hudson BY SIGNING BELOW, CONTRACTOR REPRESENTS AND WARRANTS TO ENERBANK USA: 1. Contractor has delivered all equipment, goods and/or services and completed any installation included in the contract to the satisfaction of the Borrower(s). 2. Contractor has positively identified each Borrower whose signature appears above. 3. This Payment Authorization Form has been signed by a duly authorized representative of ontractor. Contractor Date S Air Conditioning,Heating(Refrig 2.99%10-Yr Loan 1245 Brickyard Road, Suite 600,Salt Lake City, UT 84106 1-3000-1 Rev.3/13I15 �