HomeMy WebLinkAbout15-16848 CITY OF ZEPHYRHILLS
� 5335-8TH STREET
• , (s13)780-0020 16 8
BUILDING PERMIT
- � PERMIT INFORMATION - LOCATION INFORMATION �-
Permit Number: 16848 Address: 4751 TIMBER WAY
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: COURT SQUARE
Est. Value: Parcel Number: 15-26-21-0200-00000-0250
Improv. Cost: 6,466.01 OWNER INFORMATION
Date Issued: 12/18/2015 Name: WINKLER KERT C
Total Fees: 70.00 Address: 4751 TIMBER WAY
Amount Paid: 70.00 ZEPHYRHILLS FL 33542-6519
Date Paid: 12/18/2015 Phone: 813-788-4478
Work Desc: A/C CHANGE OUT 3 TON
CONTRACTOR S APPLICATION FEES
CLIMATIZE AIR OF FLORIDA , INC A/C CHANGEOUT 70.00
�
� � � �
� ,,� �2� �� �.-
J �
�� �
� Ins ections Re uired -
DUCT N ALL D
DUCTSINSULATED �
FINAL I7 —Z "�—
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 pertormed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
ONT TOR SIGNATURE PERMIT OFFI R
ERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
� a��-�ao-oo2o City of Zephyrhills Permit Application F�si�-�aaoo2�
Building Department
Date Received phone Contact for Pertnittin
� � �i�7�
Owners Name e�"'� / V(�C�I' Owner Phone Number g J "���
�•, � g
Ownere Address � � 1 YV1 �" �ryJ OWner Phone Num6er
Fee Simple Titieholder Name Owner Phone Number
Fee Simple TiGeholder Address
JOB ADDRESS LOT# �
SUBDNISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTIC�
WORK PROPOSED B NEW CONSTR B ADD/ALT Q SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM 0 OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
DESCRIPTION OF WORK � u0.� �'—�WT � 0. 3��'6'n �t►lyytp/1e (�' S ,
BUILDING SIZE SQ FOOTAGE� HEIGNT �
QBUILDING $ VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $ ��C6� o
�MECHANICAL $ �� , o' VALUATION OF MECHANICAL INSTALLATION '`
QGAS Q ROOFING Q SPECIALTY Q OTHER
FINISHEb FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
BUILDER COMPANY
SIGNATURE REGIS7ERED Y/ N �Curtrt�n Y/N
Address License#
ELECTRICIAN COMPANY
SIGNA7URE r�GisrEr�o Y/ N �E cu�n Y/N
Address License#
PLUMBER COMPANY
SIGNATURE REGiS�rtEo Y/N �cuwtEn Y/N
Address License#
MECHANICAL COMPANY C=/1 LG �!/^ v� � � Q LL
SIGNATURE REGISTERED Y! N FEE CURRE� Y/N
Address , ��� u Ovl I��. LOO t7il�SAVJ� FL• ��S3Litense# �� ��2��i
/
OTHER COMPANY
SIGNATURE REGISTERED Y/ N �cuwtEn Y/N
Address License#
f11111111 [ If111 � 111 � 11111f111111111ff11f111f11f1111111I1ff11f11 � 111
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bu�lding Plans;(1)set of Energy Fortns;R-aW Permit for new canstrucUon,
Minimum ten(l0)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/S1t Fence installed,
Sanitary Facilities&1 dumpster,Site Work Pertnit for subdivisionsllarge 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 consWcGon.
Minimum ten(10)working days after submittal date. Required onsite,ConsWction Plans,Stortnwater Plans wl S�t Fence installed,
Sanitary Faalities&1 dumpster.Site Wark Pertnit for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY required for all NEW constiuction.
Direchons:•
Fill out application completely.
Owner$Contractor sign back of appiication,notarized
If over 52500,a Notice of Cammencement is required. (AIC upgrades over 57500)
" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner author'v.ing same
OVER THE COUNTER PERMITfING (copy of contract required)
Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoVSurveylFaofage)
Drlveways-Not over Counter if on public roadways..needs ROW
. NOTICE OF DEED RESTRICTIONS: The undersigned understands that this pertnit may be subject to"deed"restric6ons"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compiiance 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. Furthertnore, 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 properiy 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 specfied 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/5ewer Impact
fees are due,they must 6e paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713,Florida Statutes,as amended): If valuation of woric 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 Consumer Affairs. If the applicant is someone
other than the"owne�',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.
COtdTRACTOR'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 consVuction,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
Lands,WaterM/astewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls,Docks,Navigable Waterways.
- Department of Health 8� Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatrnent,
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 pertnitting 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 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 fitf 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.
If 1 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 pertnit 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 O�cial 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 COMMENCEMENT MAY RESU�T 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 COM EMENT.
FLORIDA JURAT(F.S.117.03) �/ �
OWNER OR AGENT CONTRACTOR /�� "Y���'� s � /
Subscribed and sworn to(or affirtned)before me this Subscribed and swom to(or ed)b re me thls
by by
Who islare personally known to me or has/have produced Who is/are personally j� own to me or has/have produced
as identificafion. as identification.
Notary Public v otary Public
Commission No. Commi �on ��"""��.
:}:� �;:- Commissi
Name of Notary typed,printed or stamped Nam of ota ' 'p(gB aE���une 29,20�$
��P„,�4�`��, Bonded Tlvu Tray Fan Insura�e 800.385-7018
IL—
:. ������f i�����'�� Office Location:Ta�PA
Proposal Date 12/15/2015 Job Number 19680180 Sears Home Improvement Products,Inc.
Customer Name �i/r'�� P.O.Box 522290
KERT WINKLER C�� rs 1024 Florida Central Parkway
Customer's Home Phone Customer's Work Phone Longwo0d,FL 32750-7579
(813) 788-4478 Home Improvement Products Phone(800)469-4663
StreetAddress ESTIMATEANDPROPOSAL ContractorLicenselRegistrationNumber
4751 TIMBER WAY FL(CGC012538,CMC1249510)
c�� s�te TrpCode Heating & Cooling
ZEPHYRHILLS FL 33542 Is installafion within city limits?
fnstallation Address County PAsco (Yes/No : YEs
Billing Address(if d'rfferent from above) City State Zip Code Project Consultant Name 8 License No.(if applicable)
DAVID BRAZEN
� - Descri tion of the Project and Description of the.Significant Materials to:be:Used and E uipment to.be installed `
SYSTEM INFORMATION: Equipment Brand:KENMORE (Split SystemlPackage/Dual Fuel/Straight Cool/Heat Pump/Fumace):
SEER: 15.00 Cooling BTU: 34aoo.00 KW: HP AIR HANDLER Q R-410A
EQUIPMENT SPECIFICATIONS: FURNACE FUEL: (Gas/0iI/LP Gas/Electric):
Existing New MODEL#OF NEW COMPONENT AFUE(up to): Heating BTU:
❑ 0 FURNACEIFAN COIL �M4X3600AI. ELECTRICAL:
❑ � CONDENSER UNIT NXH536GKA 0 CONNECT TO EXISTING ELECTRICAL
❑ � EVAPORATOR COIL ❑ INSTALL NEW AMP MA1N PANEL
❑ ❑ PACKAGE UNIT ❑ NEW DISCONNECT ❑ FURNACE ❑ CONDENSER
❑ � THERMOSTAT 1F95EZ-0671 ❑ NEW GFI OUTLET ❑ ATTIC LIGHT&RECEPTACLE
❑ ❑ HUMIDIFIER Other:
❑ ❑ AIR CLEANER DUCT WORK:
❑ ❑ UV LIGHT 0 RE-USE EXISTING DUCT SYSTEM
❑ ❑ EVAP COOLER ❑ INSTALL NEW DUCT SYSTEM WITH# NEW RUNS
MISCELLANEOUS: � REBUILD PLENUM (SupplylRetum):
❑ ❑ LINE SET ' ❑ PAD "x " ❑ NEW TRUNK LINE(S) (Supply/Retum):
� ❑ DRAIN LINE ' ❑ CONDENSATE PUMP ❑ NEW RETURN GRILL(S) X X
� ❑ AUXILIARY DRAIN PAN ❑ Other ❑ EXISTING RETURN GRILL SIZE
INSULATION: ❑ REPLACE REGISTER(S)#
0 ❑ (Batt/Blown): R-Value ❑ DUCT CLEANING
Other:
FLUE VENTING ANDIOR CHIMNEY: ❑ Use existing vent or chimney ❑ Install new chimney liner Size:
❑ PVC Vent Pipe for High-Efficiency Furnace ❑ Horizontal ❑ Vertical ❑Type-B Vent Pipe ❑ Stainless Steel Vent Pipe
❑ 1 Pipe Installation ❑ 2 Pipe Installation ❑ Combustion Air ❑ Existing ❑ Modify
SPECIAL INSTRUCTIONS:3 TON KENMORE SYSTEM
All of the above check boxes and "Special Instructions" section have been reviewed and Customer(s)initials �Q�✓w�
explained to me.
SH1-FL (Dig.) Rev 02/10/12 Page 1 of 3
�
, �������������.��� Job Number: 1968o�so
APPRAXIINATE START DATE and APPROXIMATE COMPLETION DATE:
The work will start approximately 5-� (Approximate Start Date)
It will be substantially completed by approximately 5-� (Approximate Completion Date)
These dates are subject to change at the time the contract is accepted by Sears Home Improvement Products, Inc. ("Sears")or at any other time by mutual
written agreement. Customer understands that the Approximate Start Date is only an estimated date and the Customer will be contacted prior to this date to
schedule the actual start date.
ASBESTOS ABATEMENT: This Estimate and Proposal assumes that there are no asbestos containing materials (°ACMs") that would be disturbed in the
performance of the installation work. If upon further inspection by the contractor or others it is leamed that ACMs have to be disturbed to perform work,then
Customer must arrange and pay for abatement of asbestos by a qualified person prior to the start or confinuation of work. If Customer fails to arrange for
necessary asbestos abatement within thirty (30)days, Sears may cancel this contract upon
written notice to Customer. Customer(s)initials ��/�
PLEASE NOTE that Sears is not responsible for correcting any existing code violations or pre-existing conditions of any ductwork,piping,electrical supplies
or equipment not being replaced at this time. If additional work is required,it will be the Customer's responsibility.Any additional charges will be quoted and
approved prior to the start of any additional work.
Customer(s)initials ��
THE CONTRACT PRICE INCLUDES: Price A copy of the terms and conditions of the Master Protection Agreement or Re-
, -Year Master Protection Agreement ❑ $ pair Protection Agreement(as applicable have been rovided to Customer.
-Year Repair Protection Agreement ❑ $
Customer(s)initials �'j�✓
The TOTAL PRICE including all labor,material,taxes and any applicable discount is$ 5,466.01 Contract Price $s,45s.01
State Sales Tax( o.oo %) $ o.o0
Local Sales Tax( o.oo %) $o.o0
Customer Payment is due prior to Sears'placement of Special Order for roducts. Total Amount Due $6,466,01
The form and method by which the Customer(s)will pay is described in a separate Cash/Credit Customer(s)initials �G��
Card Payment Addendum made a part of and incorporated into this contract by reference.
NOTICE TO BUYER:YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY(FIF7H
BUSINESS DAY 1N ALASKA,FI�EENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER)AFTER THE DATE OF THIS TRANSAC-
TION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT.
� ADDITIONAL PROVISIONS
Proposal and Approval.Sears offers to fumish the materials and arrange for their delivery and installation as specified on the first page and/or the attached
sketches and specification sheets for the TOTAL PRICE shown.This offer must be approved by the Installation Department.If this is a credit sale or a payment
on comple6on sale,it must be approved by the Credit Sales Department. If this proposal is not approved or the installation cannot be made in accordance with
the law,this offer will be withdrawn and any payments you have made will be refunded to you.Any materials left over after the installation has been completed
are Sears property and will be removed by Sears.
Installation. I understand that Sears will not install the materials but will arrange for the installation.Sears is not responsible for materials or installation N0T
fumished or arranged by Sears.Sears'installation contractor(s)will obtain all building permits required by local law. For homes located in historic or landmark
zoning districts,Customer will be responsible for obtaining required approvals and related permits prior to the commencement of work on this contract.
Authorization. I authorize Sears to: (1)arrange for a contractor(licensed where required by law)to make the installation of materials; (2)issue a work order
for this installation to a contractor;(3)inspect the installation;and(4)pay the contractor when the installation is complete if I have signed a certificate that the
installation has been completed to my satisfaction.
Delays in Installation.I agree that Sears is not responsible for delays in delivery or installation due to weather,fire,strikes,war,govemment regulations or any
causes beyond Sears'control.
Oral A�greements and Changes in Contract.I understand that there are no oral agreements between Sears and me.Everything I expect Sears to do has been
included in writing in this contract.Nothing can be changed in this contract unless it is in writing on a separate form accepted by me and Sears.
Responsibility of Buyer.I agree that any information or measurements that I give to Sears are correct and complete. I am responsible for any special work
described in this contract.
Electrical&Plumbing Service. I will provide adequate electrical and/or plumbing service(s)to run any newly installed appliances or other fumishings.If the
electrical andlor plumbing service(s)do not meet the standards of the utility company or electrical andlor plumbing codes,I will make the necessary changes ai
my expense unless Sears has agreed in this contract to make the changes.
Pa�ment.I will pay Sears the cash price that covers the price of material and installation as shown on the first page.
Warranty Information.Appropriate product warranty documents will be given to me by Sears.Sears'Warranty on Installation is:
SEARS'LIMITED WARRANTY ON INSTALLATION
In addition to any manufacturer warranty extended to you on the product(s)used (which warranty becomes effective the date the merchandise is installed), i1
the workmanship(or application)of any Sears'arranged installation proves faulry within one year after the completion of installation,then upon notice from you
Sears will cause such faults to be corrected by repair at no additional cost to you. If Sears determines that repair is not commercially practicable or cannot be
timely made,then,at Sears'sole discretibn,Sears may elect to provide replacement or refund.Service under this Limited Warranty is available by calling
Sears Home Improvement Products at 1-800-222-5030,Option 4.This warranty gives you specific legal rights,and you may also have other rights that vary
from State to State.
SHl-FL (Dig.) Rev 02/10/12 Page 2 of 3
l - —
,= �������������,��� Job Number. 196so18o
� � NOTICE TO BUYER
1. DO NOT SIGN THE AGREEMENT 1FANY OF THE SPACES INTENDED FOR THEAGREED TERMS TO THE EXTENT OF THE AVAILABLE INFORMATI
ARE LEFT BLANK.
2. YOU ARE ENTITLED TO A COPY OF THIS AGREEMENT AT THE TIME YOU SIGN IT.KEEP IT TO PROTECT YOUR LEGAL RIGHTS.
�. THIS HOME IMPROVEMENT CONTRACT MAY CONTAIN A MORTGAGE OR OTHERWISE CREATE A LIEN ON YOUR PROPERTY THAT COULD BE
FORECLOSED ON IF YOU DO NOT PAY.BE SURE YOD UNDERSTAND ALL PROVISIONS OF THIS CONTRACT BEFORE YOU SIGN.
4. YOU MAY PAY OFF THE FULL UNPAID BALANCE DUE UNDER THE AGREEMENT AT ANY TIME,AND IN SO DOING YOU SHALL BE ENTITLED TC
A FULL REBATE OF THE UNEARNED FINANCE AND INSl1RANCE CHARGES.
5. YOU MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY[FIFTH BUSINESS DAY IN ALASKA
FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER]AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHEC
NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RlGHT. FAILURE TO EXERCISE THIS OPTION, HOWEVER, WILL NOl
INTERFERE WITH ANY OTHER REMEDIES AGAINST THE RETAIL SELLER YOU MAY POSSESS. IF YOU WISH,YOU MAY USE THIS PAGE A9
NOTIFICATION BY WRITING"I HEREBY RESCIND"AND ADDING YOUR NAME AND ADDRESS.A DUPLICATE OF THIS RECEIPT IS PROVIDED By
THE SELLER FOR YOUR RECORDS.
6. IT SHALL NOT BE LEGAL FOR THE SELLER TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TC
REPOSSESS GOODS PURCHASED UNDER THIS AGREEMENT.
FLORIDA HOMEOWNERS'CONSTRUCTION RECOVERY FUND
PAYMENT MAY BE AVAILABLE FROM THE FLORIDA HOMEOWNERS'CONSTRUCTION RECOVERY FUND IF YOU LOSE MONEY ON A PROJECT
PERFORMED UNDER CONTRACT,WHERE THE LOSS RESULTS FROM SPECIFIED VIOLATIONS OF FLORIDA LAW BYA LICENSED CONTRACTOR.
FOR INFORMATION ABOUT THE RECOVERY FUND AND FILING A CLAIM,CONTAC7 THE FLORIDA CONSTRUCTION INDUSTRY LICENSING BOARD
AT THE FOLLOWING TELEPHONE NUMBER AND ADDRESS: CONSTRUCTION INDUSTRIES RECOVERY FUND, 1940 NORTH MONROE STREET,
TALLAHASSEE,FL 32399;TELEPHONE: 850 921-6593.
ACCORDING TO FLORIDA'S CONSTRUCTION LIEN LAW (SECTIONS 713.001-713.37, FLORIDA STATUTES), THOSE WHO
WORK ON YOUR PROPERTY OR PROVIDE MATERIALS AND SERVICES AND ARE NOT PAID IN FULL HAVE A RIGHT
TO ENFORCE THEIR CLAIM FOR PAYMENT AGAINST YOUR PROPERTY. THIS CLAIM IS KNOWN AS A CONSTRUCTION
LIEN. IF YOUR CONTRACTOR OR A SUBCONTRACTOR FAILS TO PAY SUBCONTRACTORS, SUB-SUBCONTRACTORS,
OR MATERIAL SUPPLIERS, THOSE PEOPLE WHO ARE OWED MONEY MAY LOOK TO YOUR PROPERTY FOR PAYMENT,
, EVEN IF YOU HAVE ALREADY PAID YOUR CONTRACTOR IN FULL. IF YOU FAIL TO PAY YOUR CONTRACTOR, YOUR
CONTRACTOR MAYALSO HAVE A LIEN ON YOUR PROPERTY.THIS MEANS IF A LIEN IS FILED YOUR PROPERTY COULD
BE SOLD AGAINST YOUR WIlL TO PAY FOR LABOR, MATERIAlS, OR OTHER SERVICES THAT YOUR CONTRACTOR OR �
A SUBCONTRACTOR MAY HAVE FAILED TO PAY.TO PROTECT YOURSELF,YOU SHOULD STIPULATE IN THIS CONTRACT
THAT BEFORE ANY PAYMENT IS MADE, YOUR CONTRACTOR IS REQUIRED TO PROVIDE YOU WITH A WRITTEN
RELEASE OF LIEN FROM ANY PERSON OR COMPANY THAT HAS PROVIDED TO YOU A"NOTICE TO OWNER."FLORIDA'S
CONSTRUCTION LIEN LAW IS COMPLEX AND IT IS RECOMMENDED THAT YOU CONSULT AN ATTORNEY.
%��l� �.'"� 12/15/2015 12/15/2015
KERTIYR.�CEft
� Customer's signature Date Customer's signature Date
Accepted by Sears Home Improvement P�oducts,Inc.(°Sears")on 12/15/2015 by.
Date Management Representative
SHl-FL (Dig.) Rev 02/10/12 Page 3 of 3