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HomeMy WebLinkAbout17-18256 F CITY OF ZEPHYRHILLS 5335-8TH STREET , (813)780-0020 256 BUILDING PERMIT , f PERMIT INFORMATION �" � LOCATION INFORMATION � - Permit Number: 18256 ' Address: 6119 19TH ST 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: ZEPHYR BREEZE Est. Value: Parcel Number: 02-26-21-0190-00000-0370 Improv. Cost: 4,450.00 OWNER INFORMATION Date Issued: 3/13/2017 Name: KUHNS SANDRA Total Fees: 60.00 Address: PO BOX 1131 Amount Paid: 60.00 ZEPHYRHILLS FL 33539-1131 Date Paid: 3/13/2017 Phone: 813-748-7965 Work Desc: A/C CHANGE OUT 2.5 TON CONTRACTOR S APPLICATION FEES � BAHR'S PROPANE GAS &A/C, INC. A/C CHANGEOUT 60.00 I� � �� � � Ins e ti e uired DUCTS INSTALLED DUCTSINSULATED FINAL 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." I � 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 IIVSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER � ����-�so-oozo City of Zephyrhills Permit Application Fax-813-780-0021 �'' ,• �c : � �'�" Bullding Departrnent Date Received ' ,� Phone.Contact'foe°PePmitttn � �� — �(�j Owner's Name Q./V 1`�il.. .. � . Owner Phone Nlumber U`�—7_ � 61�5 Owner's Address f�� � / ;S� • Owrner Phone:Number ' Fee Slmple 7ltleholder_•Name Owner Phone Number ,;-_ - Fee Simple Titleholder Addreaa - - JOB ADDRESS _ Il / �� 02�� �—�,/fL`,$ �, , �3� LOT# � susoivisio� ' . , �,�cE�.��# �O� �!o al 1�19'� dD�l� �3�'D , (OBTAINED F.ROM PROPERiY,TAX NOTICE) VUORK PROPOSED s,NEW CONS7R' ADD/ALT �� SIGN' 'Q -'�Q DEMOLISH , ,B� INSTALL ,� REPAIR � PROPOSED>U$E , Q � SFR, [� COMM_ . Q OTHER . � TYPE OF CONSTRUCTION"� 'Q' �r'BLOCK " �Q FRAME � Q STEEI 'Q DESCItIPTION OF WORKI' 'j ���� �f� /� ��--OLL. � � /o'� /d � CO"m D�✓eJll� BUILDING�SIZE' � � �' SQ'FOOTAGE' HEI,GHT�.� QBUILDING $ VALUATION�`OF'TOTAL CONS7RUCTION - ' QELECTRICAL $ " , AMP SERVICE °'Q � ;PROGRESS ENERGY [� W.R:E:C. QPLUMBING :$ � " �.. . QMECHANICAL $ VALUATIONOF;MECHANICALINSTALLATION. � - y�}�8, bf�. .. , ,. . . :, . . . . QGAS � ROOFING ,Q, , SPECIAL7Y�:0 �, OTHER�, :., . FIfVISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO ... . - �,,.�.;;.�.; f:t BUILDER COAAPANY�, ... .`;'.::' ; - , . = - � SIGNATUFtE REGISTERED Y/ N . �"':'�FEECURREA." ' Y'/'Nr ' '�, ' `? , y'i> _ . , . Address ��� - _-. ` : :.� _. ,�l:lcense.#' •f' - `. - - .. „ .. � � ,. :, ;� � .. _. _.� � - -..� . . _ , ELECTRICIAN: , . , � � ;rCOWIPANY''"� � �R ;;. .+:-,... � . , ._� . . SIGNATURE ' �cisreReo Y/ N F�Isur�E��{ ��t �>�Y/-N-� ' _ ' ; . .. . _ i �-- - :',�>i".: ..: : : .: .. . . ... . i: Address ` . . , . ... . ,. � ' � Ll,cense;# -- - . _ r; -,� . .. �_ • • . _. . PLUMBER ' , �C.OAAPANY ,�::�,�..r. ;'t .. � ::�.: -. ���� •. �._ - SIGNATURE`�'`��� ��'` ` -' � � 'REGI§.T.ERED ._Y:/,:N,�� , ,- �,�.cuaREn:• =�X-;/.N ; ; - ;z - Addres$ ' � ' + 'License# s.� -- � •..� ' _ ' . MECIIANICAL` � ` . ; , COMPANY /`iF �, D %�I. -!" . �� , ;, - �;<<;. ,_= ��'S'f,�. � SIGNATURE� �`'�� 1���- � � � J REGISTERED Y/.N `..�..:; :.E CURRE�,;. ,.. Y./�N.., ,,. ,t, ,.. .. . . _ _ Z_ � . < <y ,.. . . .,....,t..�� � �,G'D 3 .�`i�.�5 . Addre�a's`� � °����!�'� �'� 'E' - fL.�� License#�` ��� � e`:�:, . , . ,. . y ,. . . . ..,. ._ . - • , - _�� =, � OTHER ,. ., .. . �. �- , . , �_,,;,y. -. - " • . ,r,...''_- f'= •r= ;COMPAPIY_' SIGNATURE•_ ..- - �, ., _�. :�.. . .� r;�;: .,_ , _. 'REGISTERED�� Y/ N..,,. �FEe'CUR���'+ Y%N ,'f�'�Fi•I!�•�<• ��•�,1_ .]-:. -.. . . . . " ." _ . _..-. e . , �. .. .- � tt• : '�,.i ' . A�I�re$S .,i,p.�.�,:r..ir: -- � � ' '4� ' ,1:1Ce�ISe 1t�" .. . ... 1 � _ , . -;; w•_ ty-:5�.:i .. ,_ j.r,,.� . . ;._. y.��...,t�."-' ::,a;.. ,.: . .:�- ._ '' RESIDENTIAL:�,. ��Attabh?(2)aPl.ot�Plans;;,(2)sefs:of'Building�Plans;�(:1)set'of�Energq�Forins;�R=O=VVxiPermit for new constructton,. � �* ;�,�;.;;,>:MinimumGRen�,;(1A)�,worlSing{de�ys�aRer;;subinitfaF:date".;Requiredonsite;'.ConsfnicBon'Plans;�Sfortnwater'Rlans�w%3tltFenceinstalled, `�''�`�Sanftery FadllUes_s�i1 ciwmpster,Site Worlc;Per►nit fo�sutidivlslons/leige�prnJects`2;:ya;.;�;�,`, : "_'�:` :�� .. � '< • `"=> ' , COMMERCIAL Attach(3)�complete'sets'of'Bulldfng Plans`plus a Life 3afety Page;(1)set of Energy Fortns.R O-VII�Permit for neW:construction. '� Minimum ten(10)working days after submittal date. Requlred onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed; - Sanitary Facilides&9 dumpster.Site,Work Permit for all newFprojbcts::All commercial res�ulrements_must meet compliance � � � SIGNPERMIT AttacFi(2jsetsof`Engineered�Plaps:�,�:�;:�~s"r�-. .-. , �.,; . . ... ` . "••PROPERTY SURVEY requlred.iqr all NEW const,r,ucdon._ _..�. •_._ � - - - • _ ._.., - -�.. Dfrections: ="'�=��:" � -� F(II out appl(cadon completely. Owner 8 Contractar sign back of applfcaUon,nota�ized If over a2500,Ta Notice;of�Commencement Is rsquUed. (A!C upgrades over 57500) , _ • v:jN' "r,fj'i'E' " Agent(for the conVactor}o"r b"'���"f�' o�ey��h�er��Id,�eksomeone wiith notarized lettef��rott►eanvr�aQthdi'izirig�ilmit,�,��� , aiv t� -�.3�,���;.aa;: : �,tiv�Y2 .,,::.,,,, OVER-THE:COUN.T,ER;.PERM NG����";��(+F+�or�t.�'A�plication�tiry)'�.�-- �' '- ,? ,.. _ ,. �"��'"'�" T;ki'fi.� 1+J 9.nfC- :�!1'�}�!�`:V�'k`.if�f `��.;i�'¢�> � Reroofsifshtngles Sewe s.::c��i�Servic�'Up�ra8es�7�/C =r�faFeric�ss,(�IoUSurvey/Footage) � Rr ;=:r'<, �1:; F a,, u �P"v� 4�1 IuF ;:?tst;s, trtni'�"� Y.,• Y�,� _'.. __...-.-...._ ��S.TO:s gt-1pi�;�4+,i..4.r�,.lifr7�li�'1�5�1 •�"i ^t ��'� '. ` -, . � �.. ';5•e.+F;'�{i o�oi,y:' _, ..e.. � ."�,a �.��,t,', ')P;k�l� i'i � iS;`�'.',tt:3iit0:.! :;<•.`cy,:r,'•'rp Drivewaya-Not over Cou ter if;onipub�tc�roadwajisi:[�'eeds`E��1�,,�:�,. ,,;; t , �,;• '�%,,,';'�.;� '�;i",+•'�• .ndLn`tif,.,a l,anai.��t,�:i tJGStn:�F: •.i�zart�i�tt�t ir{fiN�GN�ti�:�lPiliiT C'1D,f��a ,,.,�,� :�,,,�,�, �-"�a► � .. .. , . . ,. , `' +�;`-.. �;�' � _ � ....._ � �,.:,v,..,:,;,,:�,;c.�`� NO'nCE A��DEED RESTRICTIONS: The.und�r�lgned;under�tar�dsm:t�t�txthls=��rmiE�=.r.rmayr_be,sub�ecfi>to,�deed"�resUlctlons°:`µ�..,..,::�.� which m�y:'.�be=moi?e.�r�'�tt�ctive��t#ia�'Gouri�y';�ag�Mat�ons::.�'The^under�lgned'assumes�responsltifltty�for�coFn'pUan'�ce`with�2fiy �- appllcable:deed;re�trictions. � ...:,:.:.:==���:s;:3,'a�.�-�..::,��; ". • _ . ...., ..,. � .�n--�---... .. =� ��.�.:..4 �,-.,_.�..�r t�N�.iCENS�ED•nCONTRACTCfRS�:I�Nb �Ci�NTttACTOR�-RESPONSIBICiTtES::�:tfi�t�ie�°�ovmer" h�s'�tiiretl"`�"cairittactor ar contractors to undertake worii,tFrey,rriay,beirequ;li�,e:dAt6.j�beoltcensecl,lr��aacardance.with�state�.and=local;:regulaH._o..ns:t�:lf�the�'�:�`:- .-�� cor�trac#or=1s�-ndt'licerised==as-i�equi�`tiy law,�tio�`ttie ovmer a� conti��c#oT=�rrisy°�#e��a�ed�.far=�r�ml§clemesnor vlalat#on under state law. If the owner.or Intended,}a�co.n#ra�tor_are;,uncerteln as to what Ilcensing,cequirements,lmay�?epply1�for�ttie�;X��°�=��=:`N ,..,�.�.;,,... �.....:--.- ..-,_____.._.__...,�:.,,.. Int�nded vvoifc,ttiey are'advl§ei!`to ciintact.�ttie�Pasco:�Gounty Bufldingainspectfon4Dlvl�ilqn-L.icensing Secticn at.727-847- 80�9. Fuc#hermore, tf��the ouvrter`'h2is�`iiii�d�a�caii�actoT 6��corittactors� he is advised tn have,,the,can$ractor(s),�sign�,.l,,.�,_r,.;,, , portlans of the�,°cantcector.:8lock' mf..,thle,:,appllcattanTfor.,whlchn.they-wil�,.b.e�r.esponslble:-:Ifryau,.mas�.,the_ovimer,sign as the� �ontractor,that�may be an indic�tioi�'t�iat'fie Is�noE"pr��iei�y':Ilcensed an�'Is"�riot�sntltlet�=to permltt�ng priullege.s 1n P�st� ,. . ,. CDun�. " ' 't ��.a'-;:F`u'r. .�� 6_:,8dx TRANSPbRTAT14N=lMP�4CTtUT!l:6T1ES�1�lP�aCT�A1���RE��UltCE RECQYEEtY fEES;'Yhe�untleisf�iiie�unders#ands that Trenspartation 8re�pact Fees and.Reco.ucse.Recovsry_�ees.maj��;sppty<#o�tbe'kconsbucti.on;cf new�bulldtngs�fchan�e�'of�#``'�'�v`���`� use in�exis8ng bulldings,`o��zexparisl�ir�of��iklati��:•�bulli�ings� as epecffied.Ir� P�scv County Or'dtnance�number 89-07 and: .�:_... _ ._,.. 90-�?, as amencl,e,d.,.:_;Th� �ndecslgned also;,uridar�tands; ti�ait�such.fees,bas�may�,t��due,c�tittz�6e 1+denti�ed at the��time�of:����:�``����'='r permltt(ng. It Is tuirtFieir�nderstood that Tra�s��ortatlon Impaof Fees aiiit`Resour�ce�Reco�ery�fees�mua# be pald prlor to cece�ving�a'ce�tlElcate:ot�occupa�t�"'.ar��flnal�pawer-�elease. .1�the.ptajec#:.doessno�Irnrolve.a�c�rti�cate af occupaniijt=o���'�":"°=�;r flnai power.release;��tiie-;fees�irius�t�ae"paf8;prlor#o;pecmlt Issuarice. F�ttk�ermare�:If:Pasco,.County�lNaterl$e�►er:lmpact=���>,w��:�� fees are due,..they.�m,ust,be-pald,pclor.ta,,p�rmitrlss.t�ancei�ln.�ccocdance;�ii�ltf�r::appticable:Pasco'>Caunty��o�dinances. - C�N�TI3UCTtOA1`t1EN!„�.A�lV(Ctiapter T1S��tot���Stat�a���n���a�nd��): I#vaivatlon of waric is�2,500.00;or..�more;;}I�° �s ,•:���y:. cerlify that I, lhe.•:appllcant,:�-have.,been pr=ovldetl��wlkh��a~copy-.of-�the�:".1=1o�lda~Constivcttori�-Llen�:Law--Homec�wner's Protectlon Gu#de" prepared 6j+�t�ie Floi�da Depart�me�t'.of Agrlc�tt�re and Consca,m�r�AfFal�s. tf the appllcant 1s.sameone:.,.;.•.:..<Y� other than the`owner",,I certiFj►,�.th�t:l�tiave,obtainetl"a��i�ipy;of:#he4ab.ave;des.crlbed`:�'ocu�ent�and:p,ror�lsi�`In;good:,faltF�to .,.. �- :s� delive�It"to:.ttie::'owi�er"piioi�fa�comtitenceriieitt�;,s. ,. , , �. - �M . . _-. . . � . . ._ - ��NTRJ�CTOR'SiOWNER'S AFFIDAViT: i.cei�tity��#f!i�at:ali�•.thec�,informetlor�:l�r�#hi�appllcatlon t� accurat�.�nd that atl work � w(II'b� done in campliance with all.appllcable (aws regulating constructlon� zoning and;lan�`developm�nt.�Appl[catton !s hereby made:to ob#atrt��:a.permit�,�#o:�;do�wo��,and:t�istall$tton ss in�i�ete:�:r:;��l� cettt#y thet na wark�or tnstalt�tfion tias� . commenced p�io� to Issuance of.a perrriit'�and th�t�:alluwork wlll be perFo�med�ta meet-standards-�of:all laws regula�ing- �anstructlan, Gounty and Gity �des, zoning regulatlo�ns, and land devetopmer�# regtita�orisR Iri�tFie jurisdtc#1ari:t-='�t=-a1'so== - ce�lfy that 1 u�derstand that th�r�gulattons of a�the�gavernment�gencles may�apply.�.#a.the_vintended.work� and that it Is my responsib!ltty to ldentfFy�what:actlons I:mt�st�t�ke:to be:4l�=compl4a�ce�,Y:S,uch:agencl�s�lnclud�b�t�afe;not iimlted�#o..• � - Department of E�rvlronmental:'Pro'tectiori-�'`�"ress'Ba�iiead�``1l{le�and Areas and Envlrorimentatl Sensltive �YP,:,... .. y. ' Y Lands,WaterlVUastewater Trealment: .... �� "' ' � � - Southwest Florida W�#�r 6utanagament=�.t7P�#r1ct-Wells,'`"CYptes,s.��8eyliead��� �Wetland Areas� Altaring Watercourses. - . :�- - . , . - Army Corps o#Englneers�Seawall`s��':Dacks,ld�vfgatile Watarvvays, . - t3epar,t,ment:�of.,_Mealth�.,�,,,Rel�abliltafivi�;,eSer�utces/Environmen#�ItMealth°Uhtt:Welts+�Wastewater��Treat'ment, ' Sepftc`Tan�s::.... . � ' . ' .: . _ - US Envlronmerttal�Prot�tctlon Ager�cy-Asbestos�bateme,n� � - Federal�Avlatlo�.Autho�lty.=:Runways:: !understant!.that.the,:foltowtng;i�estrlctlons apply�to t�ie�se of flll: - �Use ai`flll is not,atlawed iniFlood,�Z.o,ne"V"unless expressly permltted. ' _- If the-:flll�matettalµ4ls�"fo�'tie usei�i;�In�:flvod�Zone. "A", tk !s under"stood that-�a dr�lnage pfan addiessing a , "compe�sating vofiume",wiil be submi#ted at#ime of-per•mitting w6ich is prepared by a prafessiona) engineer� " Ilcensed.by�the�tate�of:FM6flda: , - � -�• �- - . �f-th� t�ll'materlalY:ls�to tie�used in Ftood �one "A° �n.�cann�c�ian��vtth�$¢ermltted bi�ilding using stem wa11, ., . constructton,:lcertify;tliat:fill:�iaA:be;used only.to..flll the ar�a�wlthln�the�stem-wall: • � - If flll mate�la!`t� to be�used in•.anp area;' 1 �ae�tlty that .use bf�such fll! w111 not adverseiy affeat adfacent , proper#tes.. .li..use:of fili,is fot�ncF�to.adverst�Fy��ffec#adja�:ent�;pra�per#tes�.the owner may be ctted for arlbCating. -. the condl#ions��of.the;bulldirig:perrrilt�Issried�u�der ttia�atEacfied,�ermlt:appllcatlon�°for:lots�.le"ss�than'one (1) acre wtilct�er�s ele'vated��6yi�tk��engMeer�ed dr�lnage plan is requleed. If I am the AC�ENT�FOR Tk1��OWNEIt, I�.promise In_good�f.alth to Infarm°•the owner of the permltting condl#lans set forth In thts affidavtt'pr1aP ta�comine�acing constructlan. �1`uiiilsrs4ai�d:that_a2separate�permlt may be tequlred for electrlcal`v�►ork, - ptumbing,,signs� welta,.pootsi.ait`"conditioning;�:g�s;�or.oti�er":. tnstall�it�"qn� not�sp�c�laal�r lncluded�in.the�applicatfon. .A • . permlt Issued shall be co'ristcue'.d to.;be�a°Ilaense'�to�procaed wlth'�ttie;,wo�k�nd�not as:authoNty:.�to:.vlolate,:'cancel� alter, or set aside aiiy provlstons of tFie`tecltriical.c�d�s;;nor shall fssu�nce�af a.permi�.pr.event fhe�Bulldirig CNflctat from ther.ea�er � requlring a correcNan af enors.in-.plans,�consfructlan..or.irlolatlans of-any codes:� �very=p�ermtt��lssued stialF•tiecome�tnvalid unless the wrirk authoilzei�:by such perrt�lt:��s-commen�ed�wlthfn si�t.,mor�ths of�pern��t lssuance. or If work au#ho�ized by #he permif is suspended:or�:abandoned�for:a�;period;�of�slx~;(8)�montfis:�:after the tlrne the�wo�"k�ls commen�ed.. An`e�ctensta�� may be �equested� In.writing;�fram,the:Bullding,Offlclal�far a perlodtinat.to exaeed"ntnet��(90)�d�ys a�d�viilA�demonstnate �ust�iabie'cause for.�#tte e�ertstor�: I�work ce�s�.for nlr�e#y.{90)cons.ecu#Ive�days...the�ab;is considered aba�doned. 1RlAltl�lNG Tt? �WNEf�: YOU�t,.FAl1�lRE:.:TC1,:Fi�CQRQ.AP1�lO�T1GE:��>�COMME�I��iME[+�T�NtAYr.RESUlT IN��Y�UR Pd�Y1N1�TWI.CE,FCIR�IMPROVEM�W'1'�•.Tfl;�aF�U.R��:PRQ�ERIY:��1�°.YO.U�IhF�'EWD��T�`��BTI�IN�FiMiI�I�E1N�fs;.'CQN9ULT 1MIT D �O ��1P1� TTO - . _ ., . � ,, �_R� :t. RCORtDA JtlRA�'>{F.S:.1.'!T: .. .��� -..,,. ���: . , �-- :r.� - ----- - -- � --- - — __ : . ..,....�., .. . ,.: . :. . ,. �. ._ _ . _ '_._` --- - ,.. ,�..:..... .......> --•- ._ _ �4WNERQRAO�NY� . - ` ��J'�-�, g� t � COKTRpGTO ,. rn""�- ;5_���nd swom to{or� gd}before me thts Su�sc�bed and` ot al3trm b � ` e ftii� 7.1� rn��.� � ��= r� Wfio Isfare rsanally knovm .me.or:has/have.prcduced Who.le/a� .ersnnaAy�Cn to:tne.;er:ttess�have•�frodi�ced •� as Id�ri$�astl0�. � . as idenBRca�an. I � � R + • '��G�...�- - Not�ary Publlc . �� Nofary Publlc ' Got►t�ntssRc o':••"'",•,a &YLYlA It.CAMPHELL Co atan.No. .����t, �r° r'-; Nofary Publia-State af Ptarida' � .. =• " "•= - r s 19 2017 .�'� �_.Nafa►y Publfc•St�te ql F.lorida Name ot IVo , q��#���i�fF 03�230 R}ame of Notary �' .. ission�Y Ff 034238 � _' ��'���°����°�� Banded'Throuph Nptional Notary Asan. ��'��„� �'��, BDndtd�fhrouph Natioml NWary Asan. I �'�� � s � '�, ��� �� , �,. PROPANE GAS Service Orderf Proposal d AND A/C trvc. �irce�988 8�3-7s2-5o i 3 Invoice � , WCIRK ORDER#/SERVICEMAN 74878 MAR Sales, Service & (nstailafions . �EiATE�TIME TAKEN , �3l��!f 7' -15:S� 4441-Allen Rd.: • Zephyrhii(s, FL.33541 � -TAKE�t g�t �AR� � ,, 5 D�TEITYME pRC1M�sE �� " � `�� � �f� y� � .. NOTES � rY\. �USTOMER#/l..00ATIQIV i l P'HONE# � '�� � ROUTElSEQ � MAR KUHNS, SA�IDRA ' ' N.UHNS, SANDRA � 6119 19TH S? E 1 i.� 1'�TH ST , � ` ZEPHYRHILLS FL 3354� ZEPHYRHILLS FL.�3�4� ESTIMATE TQ REPLACE A/C. �"{�� ' � ` _ �:�...,��:;:<::�->.�.=: - . ��,;N�'�;�;;,'��7�S�E�tPT-lOt1f OF WOl2K Q'FY MATERlALS&SERYlCES ' . UNIT PRICE: AMOUNT ,., : �__.,,------------------------..._____ _ _______._______--------- -----{— --_,.�_ '��'� 5e�r Fs�n�c ` c. � � � � � . JG ,L.w "��� i s � � - � ' ��2W �"- " i � � " � On e fe�e, � � � � �! i i , � i � t r i i , ., • _ i i - � '� i i i 1 I ! 1 - :: .r�������!{�l��t{�.�_.�'i 1 1 ' - � I Maii�tena�nce�?Reai�lfi'ttii�tided_6y��Ail:Equiprrterit Man eCurers. ' i Pressures l.o •HI T-Stat i i . � .R�FRlCiERANTR- ` LBs. $Re��. t I � • {`011 n ,h . • • ' Y � �- ��a f ' FILTERS x x Changed Monfhly � , 1 l U1 - � ' FILTERS x x Changed Monthiy � � K ' C! f2EGULAF2 L.I WARRANTY TOT.AL SUN1tNARY DetiuinidiSfa�:Set�S,�s.'"When here;¢,�i",. When Away f�, T Stat 80° C1 N1A�NTENANCE G�NTRACT SERVICE i L{MITED WARRANTY: AiI materials,parts and equipment are waRanted by the manufacturers' M�}�{0{)OF PAYMEtJi' CALL " i or suppliers'written Vvamanry onty.All laqor pedormed by the above named company is warranted fpr , TOT'AL t 30 days or as othenvise indicated in writing.The above named company makes no otherwanranues, [j CASH t,`7. CK# � MATERIALS i express or imp(ied,and iGs agents or.tachnicians are nat authorized to make any such warcanties on behalfofabovenamedcampany. .. CI DEBIT ❑CREDI7 C.�OTHER MAINTENANCE y FROG. W /G � I have eu�hority to order Ne work oUtlined above which has been 9atislactorily wmpleted i a9ree thai Seiler � �tetains GRe to eqWpmenVmatedals fumishetl until finat payment is matle.It Raymenl�s aot made as agread. �(J��M# � selfer Gan remove said BquipmenVmatedats al Se(ler's expense.Any Eamage resuiting from saitl rertrovat shati not be Me responsibiliry ol Seller.NE7 30�AYS.A t V2%SERVICE CHARGE WILL BE AODED MONTHLY TO I AtLUNPAIDBALANCESOVEi230DAYS.NOREFUNpS � DATE GOMPLETEC} TECN: ,��� i � ��d '� CUSTOMERStGNATURE pqTE , ��,y(�%%'L� �.`�O�C.I. TOIAL ~ � ,