HomeMy WebLinkAbout17-18515 i
CITY OF ZEPFiYRHILLS
5335-8TH STREET '
' "' (813)780-0020 18515 �;
BUILDING PERMIT
PERMIT INFORMATION - � LOCATION INFORMATION
Permit Number: 18515 � Address: 6151 12TH ST
Permit Type: MECHANICAL ZEPHYRHILLS, FL. ,
; - Class of Work: A/C CHANGEOUT Township: Range: Book:
�J Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 02-26-21-0080-00200-0020
Improv. Cost: 7,095.00 OWNER INFORMATION �
Date Issued: 5/24/2017 Name: FIRST CHURCH OF NAZARENE ;
Total Fees: 75.00 Address: 6151 12TH ST
Amount Paid: 75.00 ZEPHYRHILLS, FL. 33542
Date Paid: 5/24/2017 Phone: (813)782-7032
Work Desc: (2)A/C CHANGE OUT-(1) 3 TON & (1) 3.5 TON SPLIT SYSTEM
CONTRACTOR S " APPLICATION FEES
BAHR'S PROPANE GAS &A/C, INC. A/C CHANGEOUT 75.00
� ,
, 1/�
� �
. ;
,
�
Ins ections Re uired
D CTSINSTALLED
DUCTSINSULATED
FINAL S� �7�
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. j
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 I
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. i
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
..—��. �
� _a�a-�eaoozo City af Zephyrhills Permit Application Fax 813-780-0021
�' Bu[iding Depariment
� y .
Date Recelved p�,qne=Cantact,for�PermtttFn � t� l � �d ,� — .�� �� '
�
Owner"s Name G� t�' ��P.� L`L�.GLr�'.OII e- Owner Phone Number �l3 � ��'c�'�i3
Owner's Address � 1�,� ��e ���L� Owner PhoneNumber � 4�
Fee Simple Tltleholder Name �^ ,� Owner Phone Number �� � �
Fee Simple Tltleholder Addresa — 3 '�""Dn/ 1" ���7'd/�,�
JOB ADDRESS �� D(I��' /� l�� c�- 6�� Gp ��0'7Y/ Lf/VP�t}C� LOT# �� '
su�o�visio� �_ � PARCELID# L�� �� a� ���� a��� Dt�al� ,
- , (OBTAINHD FROM,PROPERTXTAX NOTICE) �
WORK PROPOSED �.,NEW CONSTR ADDIA�T �,,� StGN 'Q Q pEMOLISH
_e. INSTALL REPAIR
PROP05Ei3:tlSE Q SFEt Q GOMM� - Q OTHEi2
TYPE OF CONSTRUCTION Q BLOCK " Q FRAME � STEEL' Q '
L . {
DfSCRIPTION OF WORK- �
I,
BUILDlt�lG SiZE r� � SQ FOOTAGE�_� , ,HEtGHT��C`-� �
�
�
�����d���' , �-� VALUATION±Gf`F't'O`TAL CONSTRtJG`i'ION
�
QEl•.ECTRICAL $ AMP SERVICE Q PRO�F2ESS ENEFtGY Q W.R.�.C. �
�� OPLUMSlNG � . �
I
� �
I [„�MECHANtGAL r$ � YALUATlQN OF;MECHANICAl.tRlSTALLATlQN
' L__�:! , L� '
QGAS Q ROOPING Q SPECfALTY, � t)THEI2 �
FINISHED FLOOR ELEVATIONS � �—� FLOOD 20NE AREA [�]YES ;NO ;
�
1 �
B41t�DER COMPANY•� `
� SIGNATURE REGIS7ERED Y/ N FEE CURRE� Y/N ;
Addrs�s Cicense# � " ' �
ELECTRICIAN=. �COMPANY " _ , '
SIGNATURE � REGISTERED Y/ N FEE CURRE��' - Y/N
�
Addre�s � . , License# .� �
, PLUMBER ` GOMRANY - •
I $IGNA7URE" � ` `�' ` REGI$TERED Y./ N, : EEE CURRE�� ' Y•/N. - �
I .
i /�lCldreBS LIC@(1S8�#
��cHnr�rc,a�:� . � coM�ivrir. ,��r4''5 , Q 11-1���,��'�" �v��� �
SIGNATURE� s REGIS7ERED,, Y/ N . , : FEE CURRE� Y/�=N
Address`>`° 7��'� �1 � 2" 1L1� " � � License#+ ��f�� 7`"J�-���
OTHER „ ��,,�, . . ` ';COMPAPlY: .
SIGNATURE �` �` . � � �' � ' " REGISTERED" Y/ N,.. � �e cuR►tEn Y/N ,
,4+ddre� , _ - +�; t� � , Lioense#�� � -.
�... ... - . _.. ,. ., F:;_.:,.. ., °. <- "
CtEStDEN't1AL`•.'`,. Atkatch={2}„Pl�it�Platis;._(2}sets�:.af:Buil�ii�g�Plaiis;'{-1}set of Erierg}i�Faiins;R=O=W Peiirilf#oi new constrtaction, . .
�;: 4�,�,;,Minimum,t�n_(:1,0j„working;days aiter:submiEtal'date.::Required onslte,,ConstrucHon=Flans;Stormwater''Plans w%S(It'Fence installed,
� -SaniteryTFacilities:&�1;dumpster-Slte�Work}Permit.#ors,ubdivislonsAargeprojeqts, ,. ` � � ' ;
COMMEE2Ci�t,. Attach{3}•compl'ete sefs'of'Bultding Ptaiis ptas a t.ife Saf�tfy Page;�(1}set af Energy�Forms.Ft L?-W Permit for new consUvctton. ,
- � Minimum ten(10)working days after submittal date. Requlred onsite,Construction Plans,Stortnwater Plans w/Silt Fence Insta�lled,
Sanitary Facilitles&1 dumpster.Slte Work Pertnit for all new:projects..All commercial requlrements must meet compltance
SIGN PERMIT AttacF��{2)set�of�ngineer,ed�P_.laiss.. � ..��- - -° � �_ - " �
•`"•PROPERTY SURVEY required for al,l NEW canstructian.
Dtrectians: ., . . . . ,
Fill out applicadon completely. . �
Owner&Contractor stgn back of applicatton,notarized '
i
if ovee 5�500,a Nattce of Commencement la required. {AIC upgrades over:67500} i
. .� ;:,�,,�:,.,.
°' Agent(for the cantractor)'or"Powe�of;Attomey�(for,the�owner),would,be someone with notadzed letter from owner authorizing same I
OVER THE COUNTER PERMlT°fiNG� -- fFmnt o�i�(�Tlic`�tion Ont�{1 , - ._��.<., =_,:'v.�:x����.�..=.t»�.:�.�.�;�,.z�:y��1r:
\ �'Yr 71��`'�i„r�i��:� ii, 3 Y •1��•. fiiti�iJ9? .' �ey(1 1''
Reroofsifsfiingles Sewers Seniice'Upgrades�`A/G� ..:�`�Fences;(PIot�SUrvey/Footage) `� .. ;•; ,� ,,.;,, • ';a�:;�='�� x� , -
, .s bl�3i 9tr�. 7 iti �f.iti5i ) ' 7�
_ �'� ,�.' ,�._ .2 ;.;=cy .T������ `�iF„ "'(` :$ y ' I �y; r ' `crith+'^,9•` •1 �-
-' ..._ _... ... � t`. ,. a *°' �i� v t'e3...�=� it�. .,t'�,.� .ti3":,: �t�e� -`9js1 a =;': .
Drivewaya-i3ot over Counter if on putiflc`roadwrays::needs�ROW'` - �.,.�• �` , -.,, `3'•��:�•-
,��' � ' � , i.$,i��v' ty� Q f!�.; :�! ?^ fNJ;Fr:+p��� ��� .,1a+%..�:�':'.` �
'�.u�;' , . . . . ,;t,.��: i.
, ` ' � . -- - , _. . .. r �ry.�_ _-, '17[''.;';�('�.f1�'��i;�i'j...,,;�,�.' .r.�::.'. ��"'•r:�n�'� z-�
` ., v=x�v,;,+..�'�T>'.;+,>�.'-.� .Si? , `�tq3.�:,�' f ,er�`}"t�
� �
,
, ��_ �
` ' � J . �
NOTICE OF DEED It@STRICTIOTdS: The.undecsignedundergtands��th�t;this;.p�rmit�.may.be�subJect,to,"deed"r.estrictlons°=��=V '��,.:.
which may�be=more��r.esttictiveath��`Cour�ty�{�egulations:�The`:underslgned�assumes'�esponsitiiltty"'for'compllancewitFi�any�
:�.::.��:-�,,..;
applicable:deed=rest�ictions. _.,.� �: :.M: - � � � ,, . . � ..:; �. �
UNLICENSED��CONTRACTORS AND CONTRACTOR RESPONSI�ILITIES: ��•if=ttie�ovmer�has"hired��a�"'contractor or
contractors to undertake work,-they may�:be�r.e�quir:,ed�to.-be:licensed In accordance:with state.and�local regulations_:�-1f.�the����� � � -
contractor ts-not i(censed=as� requUed"tiy law,_:tiottrthe,ovmer and`conVactor,may��be��clted��for��a-�misdemeanor violation
under state law. If the owner or Inte'nde.d�:contr,actor;are..uncertaln as.to,what_Iic�nsing.requiremenfs'may��applyf��for�the,�����--�.'�°' -
intended work, they are'ad'vl"s"ed�to contact ttie Pasco County„Bullding'Inspectlon_DIvlslon-Licensing Section at 727-847-
� 8008. FurtFiermore, tf the owner�fias hlred�a corit�aotor�o�contractors, he Is advised to have the contractor(s),�sign,;, ,�
I portions of the "contracto�_Block"_.of this applicatlon for.whlch.they will.be:responsible:-. If:=you,�-as-:#he owner'stgni"as�tlie ' � �
, . _. _. ._: ._.,_....
cont�actor� that may�be an indication that`he�Is noY.properly Iicensed�anticis not entitled to perrriitting privileges In Pasco
County. ' �. ; :� �:._; . � . . _
TR�11dSPORTATION.:IIIIfPACTIUTIUTIES�rMPAC7�ANb�tESOUItCE RECOVERY FEES:�The undersigned"understands .
� that Transportatlon Impact Fees and.Reco.urse.Recove.ry.Fees rriay�:apply�,to�tf�e,construction,of new,.bulldings�?change'of`�� k'�'::''`-
use In exis8ng buildings, or::expansld�rYof;ezistin,g;�buildings,��as specffied.in Pasco County Ordlnance number 89-07 and
. ...__
90-07, as amended.w�he undersigned also;understands; ttiait�such fees;°<as��may�:be:=due;:wlll��be ldentffied at the��time�of'���� ��"�'`� �
permitting. It Is iu"rtlier understood that Transportatlon Impact'Fees an.��Resourae�Recovery�'Fees.must be pald prior to - ,
receiving a 'certificate of�occupancy"or flnal��power.release. :If the.proJect,does;:not involve,a;:certfficafe of occupancy��or`-�_�`�'��-��'":� ;
flnal power release; the�fees-.mu�t tie patd;pelor to_permit issuan`ce. Fu�tk�ermore;�If:Pascv;Count�+"Water/SewecF<Impact: :.. . -
fees are due,.they_must:be.pald.;pNor to..permftrlssuaoce.in�accordance witli�applicable��Pasco'Countji�otdinances. •
CONSTRUCTION`LIEN�LAW'(Cliapter 713� ElorJda Statute�� as amended): If valuadon of work is$2,500.00,or more,.i =�: �;c.
certify that 1, the. applicant,-have_been_provided:-with-�a�copy-of�the�"Florida��Constructton� Llen':Lavu�—Homeowner's
Protection Guide" prepared by the Florida Departme�C of Agriculture and Consumer;Affairs. If the applicant Is someone ,_ , _.
,�.,.:
other than the°owner", I certif'y,:that):h�ve;o�tained�arcopy.of.the;above.,rfescrlbed,docuti�entand.,p;tor�ise�ln;good<faith to. ,..
delive�it to.:the:`ownec"::pi�io��:to�coinmencement.' � '" '� ' ` . � .- . �
CONTRACTOR'S/OWNER'S AFFIDAVIT: I.c,e�t(ty:;tti;at�all:th�,inform�tion-,in-thi� applfcatlon is accurate.and that all work
will'be done in compliance with all.applicabie laws regul'ating constructlon, zoning and�•land�deyelopment.:Application is
hereby made to obtain_:a permit-,to;:do=work.�;and�Ifistallation as ind(cafed:�•-��I_ certify"that no work':or installation lias -
commenced p�tor to Issuance of'.a permit"and that�.all work will be pertormed�to meet standards-of.all laws regulating-_ _
construction, County and City codes� zoning regulatiQns, and land development regulattons'In the jurisdiction:> 1 ai'so
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.acttons I must�take:to be,in:.compltance, S,uch:agencles include-but�•are.not Iimited to: -
- Department of Erlvironmental��Protection=Cypress.'Bayhead�; WeNand Areas and Env(ronmentally Sensitive '
Lands,WaterMlastewater Treatment.
- Southwest Florida Water Management: :DtstMct-Wells,' Cypress.� Bayheads, Wetland Areas, Alte�ng .
Watercourses. .. , - -
- Army Corps of Engineers-Seawalls, Docks� Navigabie Waterways.
- Department,of.Health;'.8 ReY�abllitative .Services/Envitonmen#al-Health Unit-Well.s, WasteHtater}Treatment, �
Septic Tanks:.__` � ' � � --
- US Environmental�Protection Agency-Asbestos abatement. -
- Federal Av.latlon.Authority=Runways.� . -
I understand that the.foilowtng..rest�ictlons apply�to tiie use of flll:
- Use of flll Is not allowed'in;Flood;Zone"V"unless expressly permitted.
- if the�filf rtiaterfal� is to� b.e used.�`In��Flood-Zone. "A", t� Is understood that a drainage plan -addre�sing a
°compensating volume" will be submi.tted at 8me of,permitt)ng which is prepared by a professional engineer � �
Ilcensed by ttie��tate of flo�tda: � " - - _ - •
- If ih� flll-material�is to be used:(n Flood Zone °A" in�connection�with:a�permitted building usfng stem wall
_ construction, I certify,th.at fiil:will:b.e used only.to.fill the area within the�stem�wall:
- If fill material Is�to tie used in any area; I� certify that .use. of such flll will not adversely affect�adJacent
propertles. If use of flll is found to adversely:�ffect adJaEent��pr�perties,.the owner may be clted for violating �
the condltions_.of the'building`:permit is"sued'=under the�attacFied:permit appllcation,-for.;lots�.less°.than°one (1)
acre wHicfi are elevated�by flll,arr•engineered drainage plan is required.
If I am the AGENT FOR THE 01MNER, I;.promise in_good_fatth to inform the owner of the perrriltting conditlons set forth in
this aifidav(t�prior to�commer�cing construction. �I understand that a-separate permtt may be required for electrical work,
plumbing,:signs, welis,.pools;. air condttioning,{.gas,:;or othe� Instell�tlons not.spec�ically included�tn.the application. .A
permit issued shall be construed to�be a�licensei to proceed with ttie work and not as:authority:to:'vlolate;�`cancel, alter, or
set aside any provisions ofithe.tecFinical.codes;�nor shall issuance�of a.permit.pcevent the�ulidirig Of�iclal irom thereafter �
requirin.g a correction af errors in;-plans", constructlon ocviolattons of-any codes. Every•permtt=lssued shell�beaome invalid
unless the work auihorized.by such permit:�s_commenced•within sf�c m.onths of permit issuance� or If work authorized by
the permit is suspended�or,.abandoned•for-a:period of:�six(8)�months.after the tirne the�work�s commenced: An extension
. .
may be requested, In writing,::f�om fNe Building.Offlcial for a period not to.exceed�ninety�(90)�days a�d will demonstrate
justifiable cause for:the extension�. If work ceases:for ninety.(90)cons.ecutive:days�..the job�is.considered aba�doned. •
lNARfVING TO OWNER: YOUR.FAILURE�TO..R�EC.ORD.A..,NOTICE OF:�COMMEi�CEMENT.:MAY�RESUlT IN YOUR
PAYING TWICE�FOR IMPROVEMENTS�.TO:YOUI�::PRt�PERTY:��IF°.YO.tIaIN'FE�ID'�TO�'i0BTA1N�FINAI�EING;'C.ONSULT
WIT D �O AN��1 ORNEI� FORE�,� - '; . ` : :1' `,.` -
,BE . REC�R�IM�:Y�UR NOTICF.UF C�MlII�ENCEf1�11ENT'
FLORIDA JURA�(F:$_ . 03 � -- "� . ` � ~ ' ,.•: _ . .
-- _ - � - -- -` - - ----- - ---� - - ----'-,-- -- r.- - - —
OWNER OR A08NT : �- CONTRACTO �Yri� �
SLJpscrl ed and swom o aHirmed befo me this Su s and' m to(ot afll ed efore me'ttilk
�-Z -i �. � lS�nQY' �� - e � /,��ii.�r
Who Is/are p rsonally known .me or has/have produced Who.is/a p.ersonallyknown� :me or tieslhave•produced
aa IdenBflcatlon: as Idendflcatlon.
I �
� ' .
Notary Publlc . Notary Publlc
Comm � ortlmiss n� p����„ CAMP6ELL
�,,••'�P,,,� SYLVIAA.CAMPBELL o~�p �;%
,�.o.►s� �e�.,, ;r o- Notary Public.-State of Florida
I 'da . = 017
Name `,p���������g,pp�7 Name of .� n
=:� �o�= Commission#FF 034230 •,;,� oP,•� �����R�FF 034230
��OFF���•' ''��°����`�� Bonded Through National Notary Assn.
�����.� Bonded Through National Notary Assn.
_ _ . , - - - -:.;�:. ���:,�:.���, - _- = --
a� - � - . - . .- ...
. ,� _ ' `�.,. .''_ ..4,4, _. _ -. • , �� �� ' .
PROPAI�IE GAS S'ervice��Orde�Proposal
�' A1�ID AIC ►Hc.
���e�988 813-782�5013 Invoice
WORK ORDER#/SERVIGEMAt�I 7E6E7 CJN
Sales, Service & Installations � DATE/TI�IE TAKE�i ��/�1/17 1 i :�0 �
4441 Allen Rd. • Zephyrhills, FL 33541 TAKEN BY Krm ��
,.;,.�-_ . �,;:.,�:.��_>��=;�:,��;�t�=:;�-.,, DATE/TIME F�ROMISED ��/�Z+�/17 �$:��D
�'�� ������=''�"��f.�'x����� CUSTOt�ER#/LOCAT T ON AC4437
NOTE �' ' b'�
�., -� ,��;
PHOh1E# 8'13-78c-7�3�
� L� <"° ��:�-��`'-�:'� - RHONE�# �I I CFi
-:=�� �:-_��-�<.�. >.
GHOIVE�# ���;1;�,:4`��4.?��:���'`��',>6:::�.
�.:,y:...-.n_�-�: a::a:;:��...�_::�
GONTAGT �'ASTOR GARY LARSO
_ ROUTE/SEQ CJ1V '
CHURCH OF THE NAZAREhIE CHURCH OF THE hIAZAREI�E
�� E,1�1 12TH ST 6151 1cTH ST
ZE�'HYRFtILLS FL 3��4� ZEF'HYRHILLS FL3354�
� 30 5 TEMF�STAR
TCA4�4cAKA 1, LOQ�17��2��
I ESTIMATE TO RERLACE 'UNITS
-_ - _ �,�: - ,:�<,.,.
,o:
.,,.,.
x�,•. t::x=' -
�-,�: _ '
.,�:.- - v�,: - -
.o�. -s.�:` _C>.. ' -
`a,�€" - - ,;�� .5-- - -
r�}"^ ' '
�v
u1.'v� n:la.. - ;;,��� ;.5..: ;;�uA:-
w� ,�:
.'�y`::e'i';:
.v�=„
^W` _ "
...y
y}
�"�:'�f`�+ -
�..n'>Y
•l" 'y-F
�r� '�r _ - N.
- .::,�:�:�-:`'�' G AMOU T
�'j�� J'��;�`
,UNI�=PRI
��S RVCCE' E:=
ATEEIIA'L•'S'8� E S:,�r'`:�=t�;��;:�:::�:::.
,�::= -;c:�< - - ''�" °��<:�=;:;<:S�`tY .��.M,
;`:�;= ,, DESCRIP'1'IOIV'OP�INORK} - :>�. - - -n. _ _
s.±i`5�k r ...5-'`- - "r_x'•,�.�` _ _ _ - �,-'�c`,_ _ � _ .a'. �...::�.,.,
.r .e-, - _ ' ' - _
....�. ' _ _ ' _
� - - -c 4,;..
:�.F�. _ .:.y�.,..;;�i�.yG-�'-..,._
4-r����+Y- -
6 - - '
:'%�i? ',�:� _'
"y�'
" ' .�-,.,e-"'_ _
- .:Y":�5..��.t�_, JY� ��s��3 ' - ' - '
��.������.��..���..�� ���.��`r����.��������� �� �������.������������������ ��'i�� ��.��i�
� "'. � ��> c+��t�f! - �. �� - cc � �JL� i i �
� .rt�d.�t0 r. - Il J�- �d✓1 i i i
• L i i
� Cta ��`f3 = �L': .� . l�ca� . i i
Q� � �, � ��;;-.Y � (�A(� i � I
� ��~� �Y���� ' � �
II � , l � L�c Lro a o�
� - � �
� �S' a � e ��c' � �.�,,,) i i
- �
�
i � - � �
, , �
� �
p �.;.. ' /�5 �
;::fT-�,��"-sT�v",!5;:�., a:,�'-;�r== __ -- " i.R'rkd•t _ _ _ _ " --_" __ "__�,r^_. ___.c� . � �
:5:�;�,a:-_�r•�,_; = - ;�RECf3MNIEIVD�TIONS`rw ':;�•^�;��;'. i
�:a%�.,.;�: ,;��:+ - ::..r: - - ��-' �.y r :'�' i �
.;r,aw .4Js: r2:. :ii?u`r"aF-:, >i�'; ..r::+` _ I
�r�..,�_ .,.�:,;,n'=b - ---�;,ei1i?';r - -4:.��� ._ _- _- - �
;3�, 'zq',�':' _ __ _�:a: _ --.;'�.»..�,;__�� _ _;4.;,,': I I
`"AnnuaM141aintenance;Recomr,riended`Iiy�Alt;Eqpipment-Manufaefurers.=;-`=�
_ _.��,�w, - ;�;,� ,�,,�. Pressures Lo HI T-Stat i i I
_- - -',;ti=�^:r. - --- _ :�2;:1,:�.;_��.�=tc:.::.: �
, _ -_ 7.,.
-` - --..- -- '<.:-�? :�,?
- e`kEERIGER,4N7,� �f LBS:, - �e�:lbs":=;�
_ - �`r"'- ':-�i`:'^'�r=�'�P, - - s.l+'��'- I I
t:C i.J� 9 �u �:rx�:; _ - - -_�F,.��. - -_ _ -` -' _ -_ _ _ _- `- - , .�. ,
[� � w� Mf�, pS �� K FILTERS x 'Fx Changed Monthly `I I I
1 t 4y+..�,
I
I I
FILTERS x x Changed Month y
. - - -- .3-_
❑ REGULAR ❑WARRANTY --- �'�TQI'AG:SUMMARY=;;'.aw;.•{.;-,��
-- - -_ : .�;,,:.�,,,;-_.._
- _ �:s''`=.;°::;.<,: . ..
...._,.y.�r.: -F. _....:-'r.':S��ij;{.:f.t " ,"1.3��:�'='�:f, �;.: _ _ _ _ _
��°eE�uiiiiiiis�at'Settings�:;;;When here"ON"�;yWhen Away 66°o�';T-Stat,�0°: ❑ MAINTENANCE CONTRACT `'SERVICEF i'
!"^.in-�;i=:F,`.i"E;;;�ts�:;k.:..°.i::.:;.;��.....: �=h;,�::-„ - ,.,ca:'1:�. - -
, ,�<...4:,,.,>t-:,_.:;.���_-,.,:�,,., CALL i
LIMITED`WARRANIY: All materials,parts and equipment are wartanted by the manufacturers' ���rR;?;`;::`::;�^.;�IjET£{QD:;OFPAYMEIVT°�;=;';=;':`�,_�
or suppliers'Written warranty only.All labor periortned by the above named company is warranted for �'�°'�`""'` ':`-�"•-`�.`=``: ' - TOTAL t
' 30 days or as othervvise indicated in writing.The ab"ove named'company makes no other warranties, ❑CASH ❑CK# MATERIALS i
express or implied,and its agents or technicians are not authorized to make any such warranGes on
., behalf,of•above named�company. ❑DEBIT ❑CREDIT ❑OTHER MAINTENANCE �
� � PROG. W 1 C �
� I have authoriry to order lhe work outlined above which has been satisfactoniy compleled.I agree lhat Seller
retains title lo equipmenVmaterlals fumished unlil final payment_is made.If payment fs not made as egreed, CLAIM# �
seller can remove said equipmenVmaterials at Seller's expense.My damage resul6ng from said removal shall
nol be the respansl6ili(y of Sellec NET 30 DAYS.A 1 112%SERVICE CHARGE WILL BE ADDED MONTHLY TO �
ALL UNPFJD BALANCES OVER 30 DAYS.NO REFUNDS DATE COMPLETED
TECH: T� i
C/—����� � '
CUSTOMERSIGNATURE � '-' DATE J1!%W/UJL �au TOTAL � I
1