HomeMy WebLinkAbout23-5946•
5335 Eighth Street
Zephyrhills, FL 33542
Phone: (813) 780-0020
Fax: (813) 780-0021
II!1111 rljl�llj 1111111!1111 !1!1111 111111111 0 111111 1:111!1111 11;111`1�
g, -
BGR-005946-2023
Issue Date: 04/05/2023
MIMI'- F11- in
accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.b.
NO OCCUPANCY BEFORE C.O.
PE IT OFFICE
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permitting ( 727 ) 497 4963
S ? 8F . Islas .,.
Owner's Name JOSE REGIDOR Owner Phone Number 608-481-6479
Owner's Address 6444 I E �R Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS 6444 ASNVILLER ZEPNYRFIILLS EL 3JJ42 LOT#
SUBDIVISION SILVER C;AKS VILLAS PARCEL ID#
(OaTAiNED FROM PROPERTY TAX NOTICE)
WORK PROPOSED � NEW CONSTR � ADD/ALT SIGN DEMOLISH
INSTALL REPAIR
PROPOSED USE SFR COMM x OTHER vnc REP ACEMENT
TYPE OF CONSTRUCTION BLOCK FRAME STEEL
DESCRIPTION OF WORK ECO HVAC 2.5TON 15SR CARRIER HP MODEL 25SCA530A003/FV4CNF003L00
BUILDING SIZE Sol FOOTAGE 1492 HEIGHT
BUILDING $ = VALUATION OF TOTAL CONSTRUCTION
=ELECTRIGAL
PLUMBING $
MECHANICAL $ 1 Q66
GAS ROOFING
FINISHED FLOOR ELEVATIONS
AMP SERVICE PROGRESS ENERGY
VALUATION OF MECHANICAL INSTALLATION
SPECIALTY = OTHER
FLOOD ZONE AREA =YES NO
W.R.E.C.
BUILDER � COMPANY �.®�___._����
SIGNATURE REGISTERED Y / FEE CURREN Y 7 N
Address License #
ELECTRICIAN COMPANY
SIGNATURE REGISTERED ;;;; FEE CURREN Y /
Address License # ���� n
PLUMBER COMPANY Em ..mm �mm^
SIGNATURE REGISTERED Y / N FEE �URREII
Address License #
~
MECHANICAL COMPANY
AIRS RESCUE ROOTER / DE�INIS ZACEK
y
SIGNATURE REGISTERED Y % N FEE CURREN Y / N
Address 3340 N SCHERE DR S A&B ST PETE FL 33716 License # I CMC1249753
OTHER FCOMPANYY ! N FEE CU-
SIGNATURE REGISTERED RREN ��
Address License #
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction,
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plaits w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsltarge projects
COMMERCIAL Attach (2) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction.
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, StoRnwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
****PROPERTY SURVEY required for all NEW construction.
Directions,
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2600, a Notice of Commencement is required. (A/C upgrades over $7500)
** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (copy of contract required)
Reroofs it shingles Sewers Service Upgrades A/C Fences (Plot/Survey/Footage)
Driveways -Not over Counter if on public roadways..needs ROW
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
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 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 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 poor 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 poor to permit issuance. Furthermore, if Pasco County Water/Sewer Impact fees are due, they must be paid prior
to pen -nit 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 1, the applicant,
have been provided with a copy of the "Florida Construction Lien Law —Homeowners Protection Guide" prepared by the Horde Department of
Agriculture and Consumer 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'S/OWNER'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
Lands, Water/Wastewater Treatment,
Southwest Florida Water Management District -Wells, Cypress Bayheads, 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 W" 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
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 stemwall.
If fill material is to be used in any area, I certify that use of such fill 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 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 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 permit 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 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, the job is considered
abandoned.
OWNERORAGE N11--
Subscribed and sworn to (or affirmed) before me this
Who is/are personally known to me or has/have produced
as identification,
Notary Public
Commission No
1901MM
Subscribed and sworn to (or affinned) before
teys
�23 by_aFNNIS ZACEK
Who is/are personally known to me or hA,§/have produced
PERSONALLY KNOWN , "raffiration.
Notary Public
Commission No.
LAUREN PFLEIDERER
Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped
Notary Pbhc - Slate of Florida
Commission P ails01,3389
MY C'onnrn- Expires Jun 22, 2024
Fill Document Template
e1 Home Improvement Agreement: Page I
Home Bevot License #'s - For the most current listutz visit
)01440, EC13007199, CGC1514813, CGCI522717, CGC061641, CRC046858, CACI813767, CACI818831, CFC1426021, CCCI331113,
1331130, CCC058300
Jerad Jacobs
Salesperson Name Registration # (Req. in CA,+1~3',PY E,MD,MI,NN':I,DC)
Horne Depot U.S.A.,hre,("Hoare Depot") or Authorized Service Provider named below will furnish, install and/or service the equipment listed below at the
price, terms and conditions as outlined on this form.
1. Service Provider Contact Information
Jerad Jacobs Atrrerican Residential Seruiues of'lanrpa
Service Provider Contact Nance Set -vice provider Company Name
7273088(160 I jJacabsars,com CMC149753
Phone # Service Provider Email Address Service Provider License #(s)
2. Customer Information
R gidor Jose 8929 F'32377479
Customer Last Name Customer First Name Store # 1 Branch ]Name Customer Lead/ Pt0#
6444 ASHVILLE DR Zephyrhills PL � 317542
Customer Address City State Zip
6084816479 _ 608481647=jr.racing(z,ltotnraiLcom
Home Phone# Work Phone# Cell Phone# Customer Entail Address
3. NOTICE OF RIGHT TO CANCEL.
YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY CONTACTING THE SERVICE PROVIDER OR
STORE DIRECTLY-, EMAILING SERVICE PROVIDER AM
jjace+bs�u?,ars.com
OR DELIVERING WRITTEN NOTICE TO HOME DEPOT AT
3n340 chererville dr n Pinellas Pat k Florida 33716
Address City State Zip
BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A DIFFERENT
CANCELLATION PERIOD, THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW
IN YOUR STATE. YOUR PAYMENT(s) WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER DOME DEPOT'S RECEIPT OF
YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE.
ADDRESS, AND IN SUBSTANTIALLY THE] SANIF CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS
DELIVERED TO YOU. OR YOU MAY CONTACT HOME: DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME;
THE LAW REQUIRES TILVI' THE HOME DEPOT GIVE YOU A NOTICE.' EXPLAINING YOUR RIGHT TO CANCEL, PLEASE SIGN
BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN €)RAL, AND WRITTEN NOTICE OF YOUR RIGHT TO CANCEL.
Acknowledged by:
Customer's Signature Date
The Heine Depot -245a Paces €arrp Road, N.W. Bldg, 13-3, Atlanta, t,a,.rgia 30-139- 0istoiner Care: 1-800-466,3337
s�aoesz"GanDr, 126, t.t
MR
3!16123, 1:58 PM Fill Document Template
Hume Improvement Agreement. Page 2
4,Description of Work to he Performed
A detailed description of the work to be performed is included in the paragraph entitled Scope of Work, Specification, Customer Summary Sheet, Quote
Form, Estimate, Invoice or Measure which is included in this Agreement.
5,Antieipated Delivery Date 1 Installation Schedule
Approximate Start Date: 311Ci12� Approximate Finish Date: 31I61= All dates are approximate and subject to change based on
unforeseen events including inclement weather, permitting delays, and delays in confusing insurance coverage of Your claim for any repair, if applicable.
6.Eleetronic Records Authorization
You arc entitled to a paper copy of this Agreement if you choose. If you consent to an c-mailed copy, your consent applies to this Agreement and all
subsequent documents and written communications related to this Agreement, By contacting your Service Provider, you may update your email address,
withdraw your consent, or obtain a paper copy of the Agreement or related documents at no charge. By providing your consent and verifying your email
address above, you confirm that you have access in a computer that can receive and open emails and PDF documents.
?.Contract Price and Payment Schedule
Payment of the Contract Price is due upon signing unless a different payment schedule is required by law, specified below or in a payment addendum.
Contract Price: $ 10000 Includes all applicable taxes. Excludes finance charges.*
Sales Tax: $ � (If applicable, total amount of taxes included tit Contract Price)
*Afavitrtum deposit ONLY applicable tit MD, MA, Aft' (33%), ,�r3, ITY (99%)
Deposit % � ._ _. �� Deposit Am�ount S = Remaining Balance S 0 �
Any interest payments or other finance charges will be determined by Customer's separate cardholder or loan agreement, to which Home Depot is NOT a
party, and will be in addition to Customer's payment under this Agreement. Customer is subject to the terms and conditions of the cardholder or loan
agreement, as applicable. No funds should be made payable to Service Provider; however, Service Provider may collect Customer's payments made payable
to Home Depot.
9,Acceptance and Authorization
By signing below, you authorize Home Depot to: (a) arrange for Service Provider to perform any Services or (b) order and arrange for the delivery- of
special order merchandise, including special order merchandise that may be custom made, as specified in this Agreement. Do not sign ifblank or
incomplete. (Service Provider's or permitting information may need to be provided to You later.) By signing, you acknowledge that. (i) You have read,
understand, and accept this Agreement in its entirety, including the General Conditions and State Supplement, if any; (it) You are receiving a complete copy
of this Agreement; fill) all rights and interests under this Agreement are solely vested in the person listed as "Customer" above; and IN) Electronic
signatures will be deemed originals for all purposes.
Customer's Signature Date
rs Tltc Flotnc Depot 3r lb 2023
The Home Depot Digital Signature Date
For questions related to your installation, contact Service Provider at 7273088060
For any other concerns, contact The Mine Depot tit 1-800-466-3337
The Hon¢ Mp.t - 2455 P.— F—y Road, N.W. Blagr, B-3, Atlanta, Georgia 303,P) - Ctstotner Care: 1-800.466t337
320 HlAC Ag,--.t f 14 N., 2 t) (C) Ge, rnted Date 3.l 6t?023 Lcad!Pori 3, 3774?o v 26A A
am
Fill Document Template
Home Improvement Agreement: HVAC Installation (Scope of Work)
New Equipment and System Design Information. Needs are deterinined based oil 12,000 HTI-VTon-
Full Manual 3 or Block Load Heating Load Calculation(BTU): Cooling Load Caltulation(BTU)., Sensible/Latent Heat Ratio.
computed
30000 30000 i
Unit Drand Model Number Standard Parts Warranty
ry
"AC Heat Pump Carrier
M Ali- Handler Furnace Carrier
Coil
Thermostat Nest Pro
Other
Other
Labor Warrant),
u
Termlyears) Dee ductible Price
I ["" 3 L-) 5 i. 10 Other d None $
1-year warranty is provided by Home Depot effective for I year from date of installation. Extended Warranty, if purchased, is provided by honk depot
through Service Net/AlG and you will receive a warranty certificate byroad from Service Net. 117certificate is not received within 60 days of installation
please call Sersue Net at (866) 413-8201, Any non-equitnent work, e.g. dretwork, refrigerant replacement, venting, gas line, routine maintenance, etc,, has
a I -year warranty only.
Recommendations: Ac"pted Rejected
Reconnect
Ductwork: G 0
Reconnect
Electrical: 12
Ncst Pro
Thermostat:
Reconnect
Refrigerant Line:
Other:
Additional Notes,
CUSTOMER ACCEPTANCE - I hearby authorize the recommendations selected above. Customer acknowledges that warranties do not apply to
rejected recommendations.
X
Customer Signature Date
1 X GIs/ The Home Depot 3/16/2023
Service Provider Signature Date
The Bv repot -2455 I's— F—y Rood, N.o% Bldg. R-1,Aff-m Georgia 3033q,0w,Gars: 14M46(0337
320HIVAC, Agr,ont (14 Rin 21 } (C) Go—t,,d Mw 3,?-( 1�3 LH04LJ�:,71479 v26,1,1
ME
3/16/23, 1:56 PM
Fill Document Template
tK
4� Home Improvement
SCOPE OF WORK: Complete each box with YES,
OUTDOOR UNIT
New outdoor unit pats?
Use existing outdoor unit pad?
Vibration isolation pads
Agreement,
NO, or N/A
Yes
(Not
No
I3VAC
Applicable)
'/A
Installation (Scope ofWork)
REFRIGERANT AND REFPIGERANT LINES
Install and connect new refrigerant lines
Flush & reconnect existing refrigerant litres
Yes
No
N/A
then:
ompressar sound blanket
ELF CTRICAL
Yes
No
N/A
INDOOR UNIT (air handler or furnace)
Yes
No
N/A
Reconnect existing electrical at indoor unit
�
New Evaporator Coil
Reconnect existing electrical to outdoor unit
Reconnect to existing flue piping
New indoor electrical included III proposal
�!
New condensate pump/lineidraln,ov'eltlow pan/safety
New outdoor electrical included in proposal
FA
switch
eoonnect to existing condensate
Electrical rude pa (
u ace note)
'
pump,=`lineldrainloverflow pan
ew flue piping venting through foundation, roof,
ew electrical whip
wall, or chinnnev, and sealed
Reconnect to existing gas or filet tine
_,
Veatherproof disconnect box
1
New gas or tact line - SEE NOTESJ
Other:
DUCT SYSTEM
Yes
No
N/A
COMFORT CONTROLS s
Yes
No
N/A
Ductwork is properly sized 4, 400cf n per ton
Reconnect existing thermostat
Reconnect existing ductwork to new equipment
Install nevv= thermostat
ew return plenum transition
7
Zoning added
New supply plenum transition
J
they:
New return drop ductwork
OTHER
Yes
No
N/A
New filter rack
Permit (if required)
`
[)network modifications (see notes)
Reprove old equipment from jobsite
_
ACCESSORY SYSTEM F
Las
No
N/A
Remove old ductwork from jobsite
Air CloanerlAir Purification
�
All pilot lights lit (furnaces and water heaters check
�
)it)
Humidifier
0
._:
,lean work areas and remove trash
"Itllation
)truer:
D In' :
Other:
NOTES.
CUSTOMER ACCEPTANCE - I Nearby authorize the work described above.
t.,_._......_ __" _ .._._ __. __... ........_ _._..._. ._.... ...,...T__.. _.__. __w_.. .,..__..._ ,.....__..._....___...
... �......_... �_.,__._.._ _,._....____..__.....
Customer Signature
Date
%
Cr-2{?23
Service Provider Signature
Bate
The Hume D,e t- 24+3 Paces 11errT R..d, N.w, Bldg, 0.3, Atiatrta, G-rgla 30339- Custom€r C.— 1-800466,3337
320 HVAC Agreemaeu (14 tut,. 20 (C) G,,. rated Data 3/ ix?">Q'3 L-1,110P 3 377 A79 v 26. L1
4 , rX &perentType.,, 4/12
3/16/23,1:58 PM
Fill Document Template
,ur`
RRThe
Ris 4%11'
Home Depot General Terms & Conditions
L DEEINELLQ�LS "AgLe -V=" imams (1) the Home Improvement Agreement between You and Home Depot,(11) the following listed documents, and
(111) any documents referenced in or attached to any of the following listed documents: (a) any Change Orders; (b) the State Supplement, ifany; (e)
these General Terms and Conditions (�G �neral C anditions-); (d) extended installation warrant), documents, if any; and (e) the Scope of Work.
"Defect" means any Services that are found to be non -compliant with manufacturer's installation instructions, "Home" means the real property,
fixtures and any physical improvements where the Services are pertinoried, "Set -vices" means (i) the delivery and furnishing of goods, equipment,
materials. and hardware; and (li) any related labor and services, including without limitation, construction, consultation, fabrication, erection,
installation, inspection, maintenance, repair, and testing. "SSnj)t9fV�rj- means a detailed description of work or Services to be performed,
including, but not limited to, any quotes, schedules, invoices, specification sheets, proposals, confirmation entails or otherwise. "5eUjjc hM,'del"
means air independent contractor, authorized by Home Depot, and its employees, agents, and subcontractors, means any property,
buildings, or structures necessary for the staging, temporary storing and performance of the Services. `)'ia means the customer identified in
the Agreement
2. RQhjLj2LEQL—,� Home Depot or Service Provider will complete the Services in a workmanlike manner and in accordance
with applicable law without causing damage to Your Home, provided, however, that Home Depot or Service Provider will not start or continue with
any Services upon discovery of any condition at Your Home that Home Depot or Service Provider deems in its sole discretion to be hazardous,
unsafe or, materially changes the Scope of Work. Unless specifically contracted to do so, neither Home Depot nor Service Provider is obligated to
repair such pre-existing hazardous or unsafe conditions,
3. AS5ffijNJJLJ '( N— �GFINQ� Home Depot and Set -vice Provider may assign this Agreement, or any right herein, or any monies due or to
_j�
become due hereunder, and may delegate or subcontract any obligations or Services hereunder without Your consent, This Agreement will not be
assigned by You without first receiving Home Depot's written consent, which may be denied in Home Depot's sole discretion
4, I i 4 E a) Payment: You agree to pay Home Depot in full for the Services pursuant to the terins of this Agreement. (b) Safe,
Acres-.: You agree to provide Home Depot and Service Provider Safe Access to )our Home, Safe Access moans safe and complete access to the
Work Area, including, without limitation: (1) obtaining in advance of the Services consent, permission, or relief from any covenants, casements,
restrictions, or other legal encumbrances affecting theltolork Area; (2) providing the location ofutilities, whether underground, concealed, overhead
or visible, to Dome Depot or Service Provider; (3) removing from the Work Area physical impediments, hazards, and building code or zoning
violations that affect directly or indirectly the Work Area; (4) removing unsafe working conditions and hazardous materials, including environmental
hazards, from the IKork Area; (5) Providing sanitary facilities to Home Depot or Setwice Provider convenient to the Work Area (or, alternatively,
paying for the rental costs of such facilities): (6) providing all utilities, including without limitation, power, water, ventilation and climate control, in
and for the Work Area; (7) removing from and protecting against minors, pets, guests and visitors in the Work Area; (8) keeping permits, if required,
visible at all times; (9) disengaging, suspending or terminating any security systems protecting the Work Area;(10) providing adequate temporary
storage space as needed for Home Depot's or Service Provider's performance of the Services: and (11) not interfering, impeding, impacting or
otherwise disrupting the Work Area at any time during Home Depot's or Service Provider's perfiannance of the Services. (c) No Performance:
Services are to be perfianned by Home Depot or Service Provider. If You attempt to perloon or assist with the Services in any way, You assume all
risk for property damage and for injury to Yourself and others,
120 ITVAC Ag�m-m (14 21) (C)
CzEi lied
The Mow thpO -2455 P.m Perry Road, NA. Bldg, 8-3,Ad..a., G-ria. 30339 - Coto—,, C.— 1-8044667337
Dot�11lao _23 L.,AdT`O._F3!,774-,I) v26,1,1
hftps:Hhomeservices,my.§&e)eWsp do umeh mp I,s 9C t4i lot d6dor,,i4rIM-069-SO0,00OOdSdq8Q,4t3&parent4d,-006660'0000qsDMQUA2&parentType... 5/12
3/16/23, 1:58 PM
Fill Document Template
The Home Depot General Terms & Conditions
5, rGE S Without invalidating this Agreement, You may authorize Home Depot or Service Provider to perfecto
Services beyond the scope of the Agreement ("Change Order"), A Change Order will be issued by Home Depot or Service Provider oil behalf of
Home Depot, which You may accept by signing. Upon Your signing of the Change Order, it will become part of this Agreement, subject to all of the
terms of the Agreement. Change Order may also result from Home Depot or Service Provider encountering conditions at the Work Area that impact,
impede or otherwise interfere with the perfornoince of the Services, requiring an increase in cost, time, or both. Following the discovery of any
conditions that impact, impede or otherwise cause the Work Area not to have Safe Access, Home Depot may immediately ask for a Change Order or
discontinue the Services without further obligation to You. Home Depot may also ask for a change order in the event of errors or omissions in
measurements or quantities used to determine the Contract Price. If You decline a Change Order request, You or Home Depot may terminate this
AgreemetiL
6. JIJLE�ND S The title to and risk of loss for any materials or goods provided to You that originate from Home Depot will pass to
You when paid in full by (1) You or (2) the Service Provider as part of the Services. Title to any other materials or goods provided by Service
Provider will pass to You upon completion of the Services.
7, N D (a) Warranty- Unless otherwise stated in the Agreement, Home Depot
warrants for I year from the completion date (tire "Warranty Period") that all Services will: (I) be performed with good workmanship and (it)
conform to the requirements of the Agreement. During the Warranty Period and within a reasonable time after receiving notice from You of a
warranty claim, Home Depot may, at its sole discretion (1) correct or replace each Defect, (11) authorize the correction or replacement of cacti Defect;
or (111) remove each Defect and refund all or a proportional amount of the Contract Price thereof to You; provided, however, that all warranties are
voided if(]) anyone other than Home Depot or Service Provider performs work upon or otherwise modifies any materials or Services provided under
this Agreement-, or (2) You fail to pay Home Depot in full as provided in this Agreement. Any warrantable corrections, replacements or repairs made
in accordance with this Agre
ement will not extend the Warranty Period, (b) Limitation an. Warranties: THE WARRANTIES PROVIDED IN THIS
AGREEMENT ARE STRICTLY LIMITED TO THE FOREGOING EXPRESS WARRANTIES CONTAINED IN THIS PARAGRAPH IN THE
WARRANTY SECTION OF THE AGREEMENT, IF ANY. YOU ACKNOWLEDGE AND AGREE THAT NO OTHER WARRANTIES ARE
MADE OR GIVEN BY HOME DEPOT OR SERVICE PROVIDER, INCLUDING ANY WARRANTY FOR FITNESS OF PURPOSE,
WARRANTY OF MERCHANTABILITY, OR ANY OTHER ORAL, EXPRESS OR IMPLIED WARRANTIES. HOME DEPOT'S EXPRESS
WARRANTIES ARE VOIDED FOR ANY DEFECT CAUSED BY ABUSE, MISUSE, NEGLECT, ACTS OF GOD, LACK OF PRESCRIBED OR
STANDARD MAINTENANCE, OR IMPROPER CAREiCLEANING. ANY MANUFACTURER'S WARRANTIES PROVIDED FOR GOODS,
MATERIALS, OR EQUIPMENT WILL BE PASSED THROUGH BY HOME DEPOT TO YOU, AND YOU AGREE TO LOOK SOLELY TO
SUCH MANUFACTURER FOR REMEDY OF ANY DEFECT' IN SUCH GOODS, MATERIALS, AND EQUIPMENT. HOME DEPOT MAY
ASSIST YOU wiTHWARRANTY CLAIMS AGAINST MANUFACTURERS. (c) Limitation on Damage& Home Depot will not be liable to YOU
for indirect, incidental, special, punitive or consequential damages RESULTING FROM PERFORMANCE OF THE. SERVICES, including, BUT
NOT LIMITED TO, damages for lost opportunities, OR lost profits
JLNTAT1_QN: This Agreement may be terminated by Horre, Depot for it, convenience, and by either party for cause if the other party fails to
correct a material breach within ten (10) days, after receiving notice from the non -breaching party identifying the breach. In the event Home Depot
terminates this Agreement because You fail to provide Safe Access to perform the Services, or if either party terminates the Agreement because You
decline a Change Order request resulting from unforeseen, hazardous, or unsafe conditions or conditions that materially changes the Scope of Work,
the]) You will pay Home Depot for Set -vices provided through the date of termination plus any costs or expenses incurred by Home Depot or Service
Provider as a result of the termination
The thom, Dora - 2455 Paces Ferry Rasa, N,W ffldg, ", Atlanta, Georgia 30339 - Customer Care: 1.8004664337
320 HVAC Ague—m (i,l Jim. 21) (C) G—ne"d IM, L-d PO4 h> 7fi4�? , 26A 1
am
3/16/23,1:58 PM Fill Document Template
4
N171"A
N 0
TH he ome Depot General Terms & Conditions
'O
9, This Agreement will be governed by and interpreted in accordance with the laws of the State where the
Pirricet is physically located. The parties intend for the terms and conditions in the Agreement to be complementary, consistent, and enforceable
under applicable laws. In the event any term or condition in the Agreement violates applicable law, such term or condition will be severed from the
Agreement, but only to the extent necessan� to avoid such violation, without invalidating any other term,,, and conditions of the Agreement.
10- ENjj&,LA_G4Lt—kM_ENT-. This Agreement is the final, integrated, and exclusive expression of the parties' understanding, which supersedes all prior
offers, orders, understandings, representations, proposals, confornations, and negotiations between the parties, whether oral or written. No course of
dealing, usage of trade, course ofperformance, course ofconduct, or any other evidence of additional or different tennis will be admissible to
contradict or vary any term in the Agreement.
IL If You make all payments as required under this Agreement, no security interest will be placed against Your
property by Dome Depot. If a security interest is placed on Your property, it creates a lien, mortgage, or other claim against Your property to secure
payment and may cause a loss of Your property if You fail to pay as requested. After paying on any completed phase of the Services and before
making any further payments, You should request from Home Depot or Service Provider a signed, unconditional release from, or waiver of, any
right to place any claim against Your property applicable to the work then completed. You may ask an attorney about Your rights to discharge
security irrtcrests.
11 ItJEJTJRNS: Custom order merchandise (i.e., goods that are custom made, Uniquely altered, colonnatelied,shaped, sized, or otherwise uniquely
designed or fitted to the requirements of a particular space) is non-rcturnable,and its Contract Price cannot be refunded unless Home Depot or
Service Provider (1) incorrectly ordered itenror (2) damaged ftern beyond repair. Special or custom order merchandise may be returned, and a
refund for all or part of the Contract Price provided, in the discretion of Home Depot. Please contact The Home Depot for additional details
concerning returns.
11 You can visit www,homedepot.coni > In -Store Special Orders at any
time to access Your account for the following: (1) Update Your Agreentent/Service Order Communication Preferences (email, text, Auto Call); (2)
Contact Horne Depot for order assistance; (3) View latest order status, or (4) Take action to schedule pickup for Your Service Orders. To stop any of
the following communications You may visit wwwhotiredepor.com > In -Store Special Orders to access Your account to Update Your
Agreement/Service Order Communication Preferences, contact The flonte Depot, and take action on orders.If You signed up to receive updates
about Your Agreement `Service Order(s) via:(a) Text Message Communications, You may receive multiple messages per order (including current
and future orders) via automated technology to the mobile phone number You provided, The total number of messages received depends on the
number of orders placed and order activity. Standard message and data rates apply. Not all carriers covered. You can text STOP to 97710 to stop
(You will be sent a confirmation message). Call 1-877-467-2581 or 1-800-466-3337 for help; (b) Electronic voice communications (Auto Call),
You may receive multiple pre-recorded phone calls per order (including current and future orders) via automated technology to the phone number
You provided. The total number of calls received depends on the number of orders placed and order activity. You can press 9 during a call to opt out
or call 800-1-IOME-DEPOT for help; or (c) Email Communications, You may receive multiple Enrails per order (including current and future
orders) via automated technology it) the Email address You provided, The total number of Emails received depends on the number of orders placed
and order activity,
14. LEAL) ZAINL, florno built prior to 1978 may require additional testing to determine if lead paint is present, and additional precautions if lead paint
is present, You will be informed by Your Service Provider of any additional Costs resulting from lead paint requirements prior to performing the
Work. For addAimaLM0mw,=,visit AAmwsp L,.g naiuing-tnngmm, -
The H.— Dep.t - 2455 P.-, Fern Road, N.w, Meg. B,3, Attaw., G-op. 30339 - Cao.wl Care: 1-304466-4337
320 11VAC Ag,,,�,,w (14 J.,, 21) K:4 (k,—tcd Mm, ,, 1dP01 _F321,479 , 26A,]
rentType... 7/12
3/16/23,1:58 PM Fill Document Template
FLORIDA SUPPLEMENT
Re idor Jose $929 F 32 3 77 47 9
Customer Last Name Customer First Name Store # Branch Name Lead/Customer Order #
Salesperson's Name (if any)
FL State Sup. (28 May 20) (OS-C E 1) Generated Date JLJ8L2023 Lead/PO# E42177_471 u 14A0
renti�',L-,' 0'44&E'6601 . ... ..... . P�W`X�&parenffype— 8112
3/16/23, 1:53 FM
Fill Document Template
YOU ARE ADVISED THAT THE COUNTY CONSTRUCTION TRADES QUALIFYING BOARD AND THE BUILDING AND
D ANY COMPLAINTS AND INVESTIGATIONSPERTAINING CONTRACTOR.
RECORDS OF THE COUNTY ARE
COMPANY OF C A
POLICY NO # WLR C68916483
EFFECTIVE: 03/01/2022
EXPIRES: 03/0112023
LIMITS: EL 1i! 0
MANDATORY INSPECTIONS.
INSURANCE
POLICY NO #MWZY 316648
EFFECTIVE: 03/01/2022
EXPIRES: 03/0112025
LIMITS: $1,000,000
N
NX,
STATE OF FLORIDA CERTIFIED CONTRACTOR Rt. ti MIAMI COUNTY CERTIFIED CONTRACTOR WHO IS ALSO
REGISTERED WITH THE STATE.
ACCORDING TO FLORIDA'S CONSTRUCTION LIEN LAW (SECTIONS i
1-713,37, FLORIDA STATUTES), THOSE
WHO WORK ON YOUR PROPERTY OR PROVIDE MATERIA S AN E
t r w
A LIEN IS FILED YOUR PROPERTY COULD BE SOLD AGAINST YOUR WILL TO PAYFOR LABOR, MATERIALS,
OTHER SERVICES THAT YOUR CONTRACTOR OR 4 SUBCONTRACTOR MAY HAVE FAILED TO PAY. TO PROTECT
CONTRACTORYOURSELF, YOU SHOULD STIPULATE IN THIS CONTRACT THAT BEFORE ANY PAYMENT IS MADE, YOUR
REQUIREDPROVIDE RELEASE
ATTORNEY.COMPANY THAT HAS PROVIDED TO YOU A "NOTICE TO OWNER." FLORIDAS CONSTRUCTION LIEN LAW IS
COMPLEX, AND IT IS RECOMMENDED THAT YOU CONSULT AN
https:llhomeservices.my, t`e sp1 -ch ime mplat ?da fir • It =T 69 0t)00 Sdq Q C",&parenL(, 66 ` 00q Ci A2&parentType,.. 9112
3/16/23, 1:58 PM
Fill Document Template
FL State Sup. (28 May 20) (DS-C E 1) Generated Date VI§LLOL3 Lead/PO# f3jaZL47 v 14.0.0
.P
4 "-6066d000k2 6sbl� A�&Parenffyp... 10112
arendii6i 6
3/16/23, 1:58 PM
Fill Document Template
NOTICE OF CANCELLATION
Date of Transaction: Lead/Customer Order # Ir
lF32377479
nwmm
If You cancel, any property traded in, any payments made by You under the contract or sale, and any negotiable
�t;&-Mmvwd %WXft)r-TM' WwIM:z" t%wvvKm-I
^Cancellation Notice, and any security interest arising out of the transaction will be canceled.
v .4
received, any goods delivered to You under this contract or sale, or You may, if You wish, comply with the
instructions of the seller regarding the return shipment of the goods at the seller's expense and risk.
DAYS of the date of Your Notice of Cancellation, You may retain or dispose of the goods without any further
AA%"vntwowaw-I v)��Jww
to do so, then You remain liable for performance of all obligations under the contract,
written notice, or send a telegram, to:
[acobs@ars,corn
7275884200
L
(Email Address/ Fax # of seller or seller's authorized representative)
(Print/type name of seller or seller's authorized representative)
1L3,3=40 n Schererville dr n Pinellas Park-_ orida
Li7 _6
(Address) (City) (State) (zip)
NOT LATER THAN MIDNIGHT OF:
(Date — THREE (3) BUSINESS DAYS from the date of transaction)
I HEREBY CANCEL THIS TRANSACTION.
FTC NOC (08 J.1, 19) JDS-C E 1) Generated Date 1116110 3
L..d/PO# EIZL77479 a 16,0.0
A A 1") A 'e",
0&parent40,:�W66&qb0664s MWAMparenayp... 11112
MPI
https://homeservices.my.7're5�4s.plj�Z-dVume
3/16/23,1:58 PM Fill Document Template
NOTICE OF CANCELLATION (required duplicate)
T
"Al Z
Date of Transaction: Lead/Customer Order # F32377479
- ------------------------- ------
You may CANCEL this transaction, without any Penalty or Obligation, within THREE (3) BUSINESS DAYS from the
above date,
If You cancel, any property traded in, any payments made by You under the contract or sale, and any negotiable
Cancellation Notice, and any security Interest arising out of the transaction will be canceled.
W, I -ruffb-t-1 (TUMI - raw—Nrlm
received, any goods delivered to You under this contract or sale, or You may, if You wish, comply with the
instructions of the seller regarding the return shipment of the goods at the seller's expense and risk.
DAYS of the date of Your Notice of Cancellation, You may retain or dispose of the goods without any further
obNW*iii. wy*trfall
to do so, then You remain liable for performance of all obligations under the contract.
written notice, or send a telegram, to:
Ijjaceab Fi�758784266
Qarscn___ 1___ 11------,---,—]
(Email Address/ Fax # of seller or seller's authorized representative)
(Print/type name of seller or seller's authorized representative)
1 [3340 In Schererville dr n Florida 3�3T
(Address) (City) (State) (zip)
NOT LATER THAN MIDNIGHT OF:
(Date — THREE (3) BUSINESS DAYS from the date of transaction)
I HEREBY CANCEL THIS TRANSACTION.
FTC NOC (08 JuL 19) (DS-C E 1) Generated Date Vj§LZQ3 LeadIPGO E3i_377479 v 16,0,0
I'll, III 'I" F 1'� 1'� e-,� " —, e,� 4 It", . ...... . , �1 !" mp, ... 12112
https:Hhomeservices,my,�' �64spl�-d �Ume r ilqid i o 6�1 6 MWA