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HomeMy WebLinkAbout16-17675 _;; CITY OF ZEPHYRHILLS '-' � 5335-8TH STREEf _ (813)780-0020 1767 � BUILDING PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 17675 Address: 5139 2ND ST Permit Type: MECHANICAL ZEPHYRHILLS, FL. Class of Work: A/C CHANGEOUT Township: Range: Book: Propo�ed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-12800-0070 Improv. Cost: 3,895.00 OWNER INFORMATION Dat � Issued: 8/19/2016 Name: DOUGLAS DONNA To�al Fees: 55.00 Address: 5139 2ND ST Amo nt Paid: 55.00 ZEPHYRHILLS, FL. 33542 Date Paid: 8/19/2016 Phone: 813-610-8920 Wo,rk Desc: A/C CHANGE OUT 2 TON CONTRACTOR S APPLICATION FEES BAHR'S PROPANE GAS &A/C, INC. A/C CHANGEOUT 55.00 _ ��� ���� �>� Ins ections Re uired DUCTSI STALLED DUCTSINSULATED FINAL I���� 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 I first reinspection,whichever is greater,for each such subsequent reinspection. NOTIC�: 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. "Wa ning 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. I � � CONTRACTOR SIGNATURE PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER � : e��aeo-oozo Ci#y of Zephyrhills Permit Applicatipn Fax-s�s-�eaoo2� • Building Department Date Receiv�d .. ; A . �Phone=Contact=for'Permi#tlri?°`.` V �1 3 '7�.� _ � � �� Owne�'s Na I e �L.Jt�1.� C�..� .,,�,�131tI1.vL�.+ Owner Phoae Number �f 3 ""' ��P��o7p . Owner's Adelress ��„� a'��' �.�_ �/��G�LS� '�� 'OwnerPhone Number C' � �., Fee Slmpla�Itleholder:Name ��— �� qwner:phone Number � _ � ' - -- '.'_"�'y'&t._' _ _ - . . _ . . . �.. � ,. Fee Stmple Itleholdec�Address ' • " JQBADDR SS � �l� '�"�� ��— �`H/�C.S LOT#, �� SUBDIVISI N �� � � �PARCEL ID�' �J'_ ��,-—���'� �1Q1� ���..�J� �O�� � ' � " �(OBTAlNED FROM"PROPERTY TAX NOTlGE} � WORK ARO OS�D �`= NEW CaNSTR -' ADDlALT � SICiN .�� ' 'Q" DEMOLISH _ ( . , 'T� ' , INSTAL•C REPAIR'' ' -� PROFOSED+�USE. 0:;= . 8FR� ' Q COM{VI'��', [,� `OTF{Ei2 "_ - TYPE OF CON3TRUCTION�; Q� '�BCOCFC�' '�C] �' F.RAME [ � STEEL Q� . { . . DESCRIPTt NOFWORK � /7,C Jf"AN �'=` . LP.� � .�G�/V Pb7Y] 0l1.l.�N.�� q/�I ��07N7Ja BUiLDtNG IZE.����� SQ FQOTAGE�� �_ , ;�HEIGHT�.��'= . �8 ILDING $ -.�;.::::�._ �.�r:.�r.,. _... �.. . . ., , ,. ,VALUATICIN��F`TOTALCONS'1'Rl'JCTION , � �; � .. . � , [�E ECTRICAL $ 'AIV1P SERVlCE Q` PROGF2ESS ENERGY Q W.R.E.C,: . ., � - QP tlMSIl�EG � . . _ . , : � ����„ �� - � � . . � /�f � � OM CFtAN�GA� ' $ ,,�, Y VA4;ilATtflN�OF MECHANEGAL��NSTAL�ATaON -. ��.1 t�� ( ��95, da:� p " s Q. �oo�i��, �:_: s�Ecia�.rr� a�ri�R� n . C� C� �, ��j FINISHED LOOR ELEVATIONS r FLOOp ZONE AREA , �YES. NO 2,� . , BUii.DER CpMPANY ` � � � � ' SIGNATUR R6GISTEftED Y/ N ' FEE CURRE�°' s Y l,N;•.;; .. , . r . - < -. ;. , �ddre s , "�- � - � C:Icense#'1 ' � I ELEC7RICt ,,. _. ,. ,�GOMP/1PIY , --` , .`. , . . . SIGNATUR �' REt31STERED Y/ N FEE GURREA �"'Y7 N Addr s � , . . . � , , `.Llcense.#�'�` i� � PLUMBER - • � , COMP<ANY, , �- � • : ,, - SIGNATUR ' _ „ ����i�TeFtEt��: .�y;,: -�Y/mN� :F,EE!CURREH't ., `^Y/N:,. �►ddre ::� � , � - ..4Jcense#�.I' = . . � MEGHANtG� . - ;CQMPANY ��-�/t/.f1�S f2'1 .!9l{IG�i�f�5 r���.-��L�. SICiNATURE� �"�"� ��'' � REGISTEf3ED= , :Y.I N. �.FEE CURREA' _ �Y./-N� ' x Add ��F�J' �Tjl�1J' �!�11.1� �.�. � . . _ I:Icens.e#-I`-�i'�-.�'��.Z-C�-"., . -1 . {3TNER " � .._., .. . . .. ..._: . . �`GQIy1PAFIX', � ,. - . � . • � : � . ,� -,,, ,. �, -..,::; -. :. SICiP1ATUR - .. . � °- , � , , _ . . .. ;.REGISTERED - Y/ N:.� ;FEE'CeURRE� :Y.•/;N: . , AddP9 - _ �-ss�; ;,�... . ,� , � „ _ . , • .L1C@�59�'��I I , . - _ " _� .:'y1,. _ _ s"`�sr'.s.y.x- _ j': i'n•�a{'€:d.K�.l�':-:.hw.k'v.. -`:tS.i�x"-..iiL�i?: _ .-> ., , �RE8lDEtV'E'frAL�{. ��Attadi�'2�;...P:,lot�Pians;i'2),sets:of}Bu'�ilding'�P1ans;;{1:j,sefof�Energy�Fcims;_R=Gi=1N�Permit;for.new;con�tructton� . - . .. .t,.} t. Y .�, ,�_ .. _ — - - - �M!!nt <er � : _ _ �um,.ten;(��O)y�rorltfng•;daj�,�aftar,:.sutiriilfhal�d"ate.��Requlred;gn�i.e;;�'ans�'�io�or:=Pisiis;:Stoiirwa#er'Plansw/,Silt�enae'.ins3alled;'�~=- .�.. � -.� . ��Sanitary�Fac�j4U,ig�ss,&�1pdu��ps�,r,t31te5Work�PetXrift;fcr:'subdEvlslonstlarge projects;;=;`s`�v`�7'-�r'-`;`�= -, ;.._ - ` " - COM�lER�IAt Attach(3j`i:oiiiptete�'sets of'Buflcitng'Pians pi`us a L{fe 5afety Page;('Ij set af Energy Farms.R-0=W Permit for neW constiuctlon. Minlmum ten(10)working days'after subml4tal date. Required onslte,ConsUuodon Plans,Stormwater Plans w/Sllk Fence Installed; Sa�ltary Facifi.ties&,.1.dumpstec...Site,.Work..Petmtt#ar=.�Il�newtpro�eats:=At1'ccmmerdal:requlrements musYmeeYc:gmp!lance ' , , BtGN P� iT Attadi(2)`s'ets ofEi►gi��ereil,Pietis;�<*:�.�'r"`.;;��;� ':>.- ''. = '�`; ��° '" ` - I •`"•PROP..ERTY..SURVEY requlred-tura I�NEW:consWpyon...,�..---.�„ �' � . . • � , _ ,�..1...r. �Dire,;cttons` �:�>v.-,-. , - .. .�....�.�. �. ._. _. �. . . Ftll;out epp8catlo�completely, awner&Contractor stgn back•of appticaflon.notar(zati tf'ove �2500,�Nottc�,of:;Commencemen4la required. _(A!C upgrades over S75q0),_ �;.: . _ .. 's:<�`��3=,t:;;,.r:,,:;: . ._. . : _ . ..�_. ,, , - - Agent for�ia contracto�)'or�Power"of Attoiriey(foFthe:owner)would be someone with notarized letter tram owner authorizing sam�e , ,g :;; � :w �,_ .ap,���.�r.,��..s;���.,,��;�.�;�--� 'D_.VERTHECOUNT�R.P.ERMITT1Nti:._-- Front�/�p �L. ---- � „ .,,�u�'��,;:� ,.r���.+!:�: •" , k� Retoofs If s Ingles Sewers 8r��.��_Fer�C��PIo urvey/Faotage) ,,.,:- -. . ��'� -.. �, _ ~ _ , :s-' - .{: l�i, .. . � �2 y�,...., r. c� k�.rl '�'��li ,i�. -y _ ._ .:;.�`.- '--- .:�..._,.... `�_1 .�.. i� �.'{y xi:.?�f6�C+`s�.!``�-��st�n�S[ , `' ._- , tq . . -. . ..., _�,.,_ � ., r q.;• *�4.f� ^ � fj �`��^ " I.. ,, ... Drlve ays-Not over Caunter I�on'��ib�ia roac�weys.�ieed§.�Ca4�r ,�.,,� ?� « ;; _�� . _, ' �rq: r�! .rZ z�=�i,..� c��,., ,�''��;,,.:.,, �� � , -` ,.},��[y�.c'�'`._ �4 �:�� :�•� . . xtc'y`CG;f�t-; C4 tt:'.:g'1.1i��fT4S�. ,-:.�u��' .:ji `���� �a,�, �,rn!r�'.s'�L•Y�^•C�ti�'1't�[,a�;::'71. '•r:,. `,y4 _�:y,a,�,��=x:`;- . d�''�'n"�."'���'a+��n�,�m�,. �'� P� , . �.e " � .<< � .> .. �-. ., , ,. " �� f., ._.t,a�i; h _�f .. _ _... . ._ ' . .. ' ._ _........ ........ ... ..... _...... ... . 1 .,JJ,,�_:x,��_.K ,��: OT10E OE DEED•,RESTRICTIOIdS: .The-u�derslgned:,undergt��t;tls;ti#h�it;thls�:p�r,r,niE�:may;be,.subJe�;ct:.to�"deed";:rest�lctlons��;,,. ' '-'� � . ..,.F. =:.�.�t ..-;ro< -,�•�Fcr' :r7-`.:..s;,,..�a na-:•J..�i:.�„� � c,-� :=... ��r c�, p��r.r�UC.,yt.c,.,�Yi.a,;,?h:� ,"�'xoy,�, �ca�fi„i".''+;:q`�`;riCw�);$Y,*.`..� '"�v.t„�,,.., �,cF,u�;'-:5...�.=;'r �hich may<be<,mor.e�,r,e.sttict�re:�#���i=��unty+c+�tatror�s:.'T'he;�iride�rsigned�e��untea rsspon�s�blifiy'fairrcampliance�.with:�ny� y PPilcaa�tife?d`eed�ie�trlctions. } :�:;:;.::�_ � f�r ,'�k.•34:.,r,- ,;,.,. •_ , ' _ ` _ � _ �>,N�;,�:w,�F,.=.ri,���zk.�;. NLlCENSEQ�='�CiNTRAC�;ORS�`ANQ`CO�lTRACTOR-f�ESPO�l�l�It�;l�F,�:�i.�4:�';1€:;t��ie•�oudtiier`°fi�s'�=lifre� +� 'i:��i#ractar ar, �ntractocs-to undert2ike�wairk:#heV ` : �� g:�'l�ed�toxb: � ' -ln�: r.dai�ce;with�state�:and.tocalrra��latio ��! ,�..�,��y:=._, �me be_r, e��llcer�se�cl. aExo �. �.;:.: �.t�,t;+ er,,.ld.�a�/.�� .�+i »�r. :;3�"��:_�< ;k rA'y;FS.w . "`.`:C�"r4+rfP,:,� .a_:��w�..ry...�., ���s..�l����." , �ntractoc°)slnot>licenseri;�as��requlced�tiy�law��tiofh�°theYawner and�ec�ntrac�o��m��r�b�Ycltg'rl�fair ��misderryeanor�violetfon nder st�te lew. if the owner nr int�nded;;ca;ntra#tor•:ere�.uncertaln as:to�wh'at llcensin r ulre�nents-� � "' {.;A�}==���h�� _ �..�, ,;%�::,_,�;�.y e,,,,,t ..a � .�-�,.:,..�-.,,.,.,q;a F>�,8��,�i_.�,�3;;.��.�r�,...�:!ne!Y•'�iPPi.I�'fv�.�the��:� tended'work,�titey;are$advise�t'�to:�.cbnta+ct=the:P,.as�a;,±Codi�ty�Buildin�:;lnspectionuDtvtsiori---i:icen,:s.;ing.:3ec#lon at 72T=847- , � .....:.... .... .:�. ,..._ _u...�.r,�....:.. �..,,,. ,..�,.. . ._ .._.� ,_.-,, .-. ::_. ,>_:_.:.�..�,... •-;:. . _. .:..:,.;. . 709. Furthermore;,_If4the�.oNmer,�has<`til`reil`�a.:r�int�actor.;ot�contractors; .he�is�'adiitseil��fo�have;.#�e�csan.tr�ctar(sj�sfgn,„_;.,,:;,V;.�,;:�:. ,.; �rtions of t�e "contrector. 8lock".�of'thls�appllcetlan,l�or,whlah�#hs.y.;wlll..be::l�spor�s!l�e.�-d��You►�as-_the +�wner stgn es the�-�° . ;: mtraator;,tf�at>inaji tiis�ari indicattion-`that`he�ls�not'?propeily�ficensed aiitl�is�not`�'�iritltled`�to�permit#Ing�prtulleges'in Pa�co,. , , , i'� i v ;,rt:';F: ry ',:vtr.u...:o.i'�: ounty. • r� : _ .. . ._=- --..:: .:: ,.. .. ...., .v:�_ ... . #f , �:,s�� , ... RlINSFORTA'fi0►N�IMPi4CTlUTtL�'IES:=tNiP�►G'��At�i��=i�ESOUiiCE��R�Ct3VERY��EE3:�=T���nn�der�l��e��:understands ;� � "�,` s', .�t�;��;�it ;,�, aE Tcer�sportatEon Impact Fe�s-snd.Recourse Recovery.Faes.may,:apRSy'#a t�►e con�truc�on,�of new�,b.utidings�.schange af"��_'• - s, ;e in exisk(ng-buildings;:or�fe�ipa�s�ii;i�;of��x�s�.�}atitilli�i�igs;as�specltled.in P�ssco Coiinty O�lfnance.number 89�47�and ;� )-O7, as amende.d.w,'1'f�e�,undersignetl elso�,understa�ds� tha�t�such fees;:�s,ma�r_be�:=+d�e;;u+r�llh��e ld�n�fled at th�£tlmeLof*'°���"��#�`=� !�� �.�ti-. , ,_.,.. r �; armitting. it is furfher`undere`taod th�t Tra�tisportatlon�.lmpacf°Fees �nd=�Resou�cie.F,tei�iue�`y�?Eee§.::mu�ti be_pald prtor to �� ce€ving a:"cerfffic�te.;of�:occupancy'°�or-flna��pmnrer=nlease::�:i��the.proj���does:ni��l�volvev�a=certt�tr�ate of occupaitcy:�o�;��rr��t::=" " ; ;.:�. , - ,..}_.�,,. , �al pawer,-release�,��ttie:af�es�=,tnt��t*;tie�palil�pr`ior�_to.`-peTmiE issuance. -F��tk�ermore;;��iF:Pasc�►��County;'Vllate�lSewer�lmpact���ii}:�;�-:� : • es are due�11�ey tnust�be�pafd:prior to periritt'=lsst�ance-in,.a.a�acdanca wit�r�pplfcati�fe�Pasco;County or�inances. OWSTRUCTtC1N�lEN�I.AIfll':{Ch�p't�ir 713.FIoMcl��Statu#�si a�smi�r�l�d}; 6f vsiu��an of�wark Is$Z�500:OO�or:mare;l,; �_. _ :.�:,>. �. �rtify that.,1,.:4he,>aPPlicant;.��iaxe.;been:ApraoYlded�-wlth;:�a �copy..of=;_tM�e;"Florlda=�Constntctloii=w:Ll+a�n::LaVw-Hameowner's btectlon Guide" prepared�by:the�'Florid�i`Rep�irtrne�t;of Agriculture and Con�um�r,�tffalrs. If!hs�ppltcant ts_sotrieo�e:_�.,.�;-:•���:, her than th 'ou�me�" 1 ce r ` • '..T`�':: ` . , . � �. rtffy_th�t;�i:h�ve:.oi�t��ne�r��'copy:of:the:abQve:.des,c'(�ied��dbcu�entsarid;pror�l.�e��In;gootl=�ith,to. , . �liver it to�•t�te:`o+nrrte�".prldir4<ta�ciommencemeii#�`��'"�;. =' . . .. `;- . ., . . ` _ . ;`�� . � , .,. ... - - . QNTft�iCTAR=S/01NNER'8 AP�11?AV1T; 1.ce�y�;tk�et°a!1°=th+��;ln€ormatEon;,i��.tt�is:appl#cattan is accunat�.�and that�11 virork ill'be done in complt�nce wlth all.app!lcable la�ws�r.eg�ila�ng�constfuc#ipn� zonfng and��t�rtd.development. Applfcatton is , _ �reby made to obtaln;a.' perm[tn:to��o�vr�fkJ�and.�ln�tallatlon as�Indlcafed:�x:=`I.certify"�tt�at no virork'2or lns�iltatlon�tia�s �mmenced`�p�lor'to'tssu�nci� of a perrtilt°and that`:ail�work wpl.be performed�ta meet,;standarcls,-af��!{ laws regula�ing- ifl$tfUCtlO�fr Coun#y and City codes, zoning regulatians� and iand devetopment r.�e�latloins��ln"tfie;�jurlsdtctlon:�� �I�°al'so� ; Ertify that 1 u�derstand that:the r�gut�itibns of othergovernm�nt agenafies may�app�lyr_#o,the,lntended.work, and,that it Is �r � �respansibtllty to tden#ify�what,ectlorts I:must�t�k�:t�beYin:.cor3lpliance: Su�h;agencies incl�de bttt-are;not limited:.ta: ;- • .;` - :�y; ��:�.:� r ;,,�..,..,;,,_ . ;. . .':t." ,. :: �.ti�`.*7"' 'x - Dep��trrient of-Et�v(ronmental>�Protect#�i�-Gypre�s:�B�ytie�d�; lttt'e�and f�►i�eas.and Enviroeimentaliy Sensitive ;; ; �.snds�INatedUtfastewater Treatment. `:-: � - �� - Southwast Florlda Water Managem�n�;.:Cltstrlct-Wells; ��Gyptess•s�.8eyti��ids��� 'Wetla�td Areas, Altertng" ' � ' VV'atercourses. . . _ �. , , - ��; - Army Cocps af Engineers=Seawatf"`s;�Docks,t�avigatile VVaterways. . - Dep�rtment,of„Health�:8„�Ref�abllitai�r.e Services/Ern►ironmett�af.::Flta�t#�:1litit:Weits;-.{Naste.water�vTreahnent; Sc�ptl+c,Taiiks:° `::�`T - . u ,. , .;f Y... . ,. °_ _ . . . � _ ... - - US Envlronmental Protectlon Agency-Asbestos abateme�t,;. � - Federai Avletion;Autt�orlqr,=Rurnvays:� �._ . . . . . nderstand that.the:.follpvu�ng;�resf�i�ions apply�#o tiie�ase of fllt:• � - llse of flll.l's not allow+ed:#n�FtoodSZone"V"�nfess express{y pertni#ted. - If th,e:_,fltl:�mstet�a!`sls`'ta:a5e�=!used.ln..:flood�Zone. °A",.iE�ls understood�that a drainage�plan �ddcessing a "campensating�volume"-wllf be submlited at�ime'of permittJng virl�lch Is prepared by a professfonal engfneer° Ilcen�ed�by;;#tie��tate°of;�FloHda::. . •- ',..,,� :. . - if..fh�..fllt;maferlat�;is.=ta::be used in �lood"Zoi�e "A° lns connectlon�wlth'a���erniitted building ustng stem wall ' canstruc�on,_I certify.#ha#��Il:�ralt.ti�e�t��ed'only.#a filt the.a�ea.vvithln�the s#efn��vvail. .... � _ !f fltl-mate�a!';Is»�to��ae=�used�°irr:ainytarea;�C�+ii�rti�r t�tat .use. of sucli`"filt wilt-not�adverseiy �ffffect adjacsnt prape�tles. !f use:of fill�is found�to adverss�ly-.,��i:f'ad���ra��:prc�pertles�.ths owner may be aited for utafiatin�. . the condwons;of:�ttae"b�ill�fing�zp�rmlf IssuedF�under ttie•��itt�ctied..�ecmlt���pp�c�atlo�t, for�=lots.less�than:one (1} ; acre whlch are=elevafetlrt`tjr:flll,:��tengirteer•ed dralnage�plan4ts�equlred, • _ � � ;,. �m the At�ENT:f4R�THE�t3{AtNER;il,:�ro"mi'se';1n..go�d faith to�infarm the�own.er�:of�the.;p:ermlt#ing:candl#lons set forth In f,°; ; s atfldavft`prlor'to coirimera�ing consfiictt�in: 1 uhde�st�ind�thata�seYpa�rate perdnit may be required for etectrlcal.work� , � � _ : � ,�- ; imbing, signs+ weAs,.pvols;,_elr.cond�tloning� 9�ts�,,or otNisc !ns#el�tons.:no��spedfla�lty lnEtttded•tn.the �ppticatton,. �A' -- ,,` =' rmlt Issued"�Fiall be�,co��hued�to'be::�a:llcensesto�proceed wltt�`'ttie�viiork�and nok=as�authorl#y„to ylolate;��cancel;.alfer, or � `: ' �aside any provistons�of'iFie°teclinlca);code�;�nor shall issuance�of a�perfnit�:pr.event th�Bulldlrig Ofticla!from therea�ter � �'� : �uirtng a r:�orrection_nf;emars.in,plans;,;cotistruc#ton,orvloiatlons�of any code�.�<�very:�p�ertnit�lssued�hall:becdme.invalid �� �:� less the woi�c siu#tioi�zeil'by sitcti"permiY��is.i��iimen�ed witliin:s�t:,months�of:�p�rmit Issuance, or if work authorized by �`�+ ' t ,.:�v-i:i' t�a k �perm(t ts suspendad.yor,abat�do�ed:�for a:#��r:lad�o�.zs�t{8);monffis;:afteF•flae tim�#he�work-as cammence�i. An extenston - k.`; ! iy be requested, In writl�ng,ftom th'e Qulltling C�clal.�for a perlodwnot#o exceecl5nlnety�(9i�)����ys�a�id:wlfC=�detnon"strate �: ; tlfiable cause'tor.the exfenslon:�If wc�k,aeae:�es,for nlnety�90)conaecuttve:day.s�_the�ob�ls�considered abaadoned. . ';? � iRNIN� TO%�}WNfRs``YOU :FAiLtIR t1.° �E.C: ' -� ,>:? ;.. .:-ti.. �µ,. . , . -� - ;� � r R' �'=7 ,�R Otti�rA�MOTIGE;;OF:Ct1MME�ICEMEti�T:�dViAYsRE$ULT IN�YOUR, � ..., .:r......._.:...._ .. ....:.. .... � i YING T1N10E FQR�:tMFFkO�fEMEI!,��'��T�.�Y-C��li.�>PA�AEI��.�',I��:Y9.t��1�''€���'T�;��l��N1��1����3S�p��O�l�ll6�' --� _.-�--..- -�_ :,..,. , .. ..... _. ._. ..: . . r vOu �o N��° O N � R .� � ��f"�0�� �� � =4- � � � ►RIDAJURA�•(F.S:t1 ,.03)_ .. .' . � . ,� � � t .� _ �, . ' .... _ .. � . ; . - NER dR A08MT CtkA!'[i�11�'O�� , . sarlb /and ewo to afllrtned)ba me thlg" '" ' " S" "e bedJ'snd' =to(ot afflrtn drbefore_me:Ni19, . ; a _�40 � �'} �./` �! `i� ,�:. � fm o. .. l5 F,�=�,r .,. ►Is/ar erson�ll Itnown to•ma�;lden8flca8�nraduc�t! Whn.tslere ecsanelly owRr:to.m.e;or#�a�lttave�todin�d. . _ . . '".. _, , ` 'as�ldentlfloatlan. . N .. .. .3 } �+ li _ • Nn�ry Publta . Notary Public imtssRs a: ,r,,,r,,,,�� ` Com elonNo.._,�._ . ,�•`a"r"n"B� SYRV#A11.CAN►p8fl.l � =���tp 6`%= 5 -� N' � ., � �a ot Notary typ _ JI s ida Name ot Notary � ' � m Expires Jul 19,2017 u61ic-St�t�o}F�p�d�., , "�,•_">�.�;` Cr�mmission #FF 034230 ��y T�'��U�amm.Explre8 Jul 19,201� r'+''� • " .T . .c�Nat�ona!NotaryAssn. '�k �' Commis8ion aY FF.034230 .. � � -�,.,,� �^ �� . ���"'��`�}`'��r Bortded lhrougA M�t�ttit NO2?t�r At�n: _ . ,. ..� K , .�,� . ,�-, � �• � PROPANE GAS Service Order/Proposal � � � � �� - /�N� Q�C INC. Air Conditioning 8 Heating 5��� �9� s i 3-�s2-5013 ` WORK ORDER#/SERVICEMAN 7�0�E JUL Siales, Service & Installations ' �ATE�TIME TAN.EN �7I;�7/1E �8: 3� 4441 Allen Rd. •.Zephyrhilis, FL 33541 TAKEN BY �,1� ��► VOTES• I DATE/TIME F�ROmISED ' � CUSTOMER#/LOCATI01� ��FJ�J F'HQNE# 813-E,1�-89c� I � ROUTE/SEG ' ' • JUL , DOUGLAS, DQIVIVA DOUGLAS, DONNA 513`� �:NP ST �13'3 �ND ST ZEF'HYRHILLS FL' 3�,�4� ZEF'HYRHTLLS FL3�54L . ,, � . �T��, -��:��.d��,,-2.., r1� SP►� �' � , EST I MATE ,� � �� �' , � DESCi21PTION'-OF:WQRK-� � QTY. NIAT�R1Qi:5•&-SERVIGES , UN1T PRICE AMOUNT I - - n / � , �� oc - ��.____ .________ ..- __.______ ____ ._ ____T ____________ __._ �__ __ ...�__ _ c �- c --- -,� ��:, - -- c ( , � �� ASf` C.. � C1S �� � � � � w, � , � � . � 3 9 �o � . .. � � � q�- � `� �„ G.�:� � �.n S�t- � � � � . � yc� � � Q �' ji a� c ' ' ` ' ' ;cL < ' � �'� , I I I � i � � " , � -" R�COMMEND'R,TIONS , r;.%;:'=`r 4 ' ' i � Ann�al`Maintenanc��=Recommended by All'Equipment Manufacturers, pressures Lo HI • T-Sta� � � � i i REFRIGERANT R= LBS. S per Ibs. � i . FILTERS x z Changed Monlhly i � • FILTERS + ,c Changed Monlhly � � I ❑' REGULAR 0 WARRANTY TOTAL SUMMARY Qe�►uniidist'at'Seffi gs: When here"ON", When Away 60° , T-Stat 80° Cl MAINTENANCE CONTRACT SERVICE � LIMITED WARRANTY All matenals,parts and eqwoment are warranted by the manufacturers' MEl"HOD OF.RAYMENT CALL • � x suppliers'written warrant only.All labor pe�(ormed by the above named company is warranted for , TOTAL i 30 days or as othenvise ind cated in writing.The above oamed company makes no other warranties, ❑CASH ❑CK# MATERIALS i �xpress or implied,and its genls or technicians are nol authorized to make any such warranties on � �ehati of above named com any. ._ _ ❑DEBIT ❑CREDIT ❑OTHER MAINTENANCE � i nave aut�onty lo order lhe ork oullined above w�ic�has 6een sauslaz�only complete0.I agroe that Sauer PR�G. W � C �' �atems Utlo�o aqwpmenUmate�ials fumishod untfl final payment is mutle II paymonl is noi maae as a¢reed, CLAIM# I seiler can rertave soid eqwpm nVmnlenals al Seller's expensa My tlnmage resWting Irom said removal sMll � not Do the respansihllity of Sell c NE7 30 DAYS.A 7 1/2ao SERVICE CHARGE WIIL BE ADDED MONTHLY TO 4LLUNPAIDBALANCESOVE aoonrs.No�eFUNos . DATE COMPLETED • TECH. T�a ' � �US70MERSIGNATURE I DATE �//(-Q%�Ltt ��CJC(- TOTAL � �� s � I � I