HomeMy WebLinkAbout05-3886
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
3886
Permit Number: 3886 Issued: 221/2005
Permit Type: GENERAL BUILDING PERMIT
Class of Work: 434-ADD/AL T RESIDENTIAL
Proposed Use: NOT APPLICABLE
Sq. Feet: Est. Value:
Cost: 9,205.00 Total Fees: 120.00
Amount Paid: 120.00 Date Paid: 2/21/2005
Address: 37433 BLACKBERRY
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: WEDGEWOOD MANOR
Parcel Number:
Name: SEARS HOME IMP OVEMENT PR DUCT
Addr: 1024 FLORIDA CENTRAL PARKWAY
LONGWOOD,FL. 32750
Phone: Lie:
Work Desc: CHANGEING OUT WINDOWS 9
ED'1'aRD & LOI HLlCHTING
374QBLACKBERRY CT.
ZEPHYRHILLS, FL. 33542
Phone:
F LUMB
DUCTS INSTALLED PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB
DUCTS INSULATED LINTEL PRE-METER WATER
SHEATHING FRAME MISC SEWER
MISC INSULATION WALL MISC MISC.
MISC. INSULATION CEILING MISC. MISC.
MISC. DRIVEWAY MISC. MISC.
REINSPEcnON FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Thirty-Five Dollars ($35.00) shall be made for each trip for each trade:
(a) Wrong address (b) Condemned work resulting from faulty construction (c) Repairs or corrections not made when
inspection called (d) Work not ready for inspection when called
(e) Permit not posted on job site (f) Plans not at job site (g) Work not accessible
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
"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."
NO OCCUPANCY BEFORE C.O.
~~~'~LLL -~.
CONTRACTO S SI ATURE PERMIT OFF I
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
v~lIUV,UU4/J4VN U1:UO HI L.trjjl~l~ W1WJlN.. ~A.\ ho.~lj"/~U-UULJ r.UUI
CI'l'Y OF ZEPHY1UIII.LS PEma'l APPLIeA!'ION
IIOII.D:DIO ZlUU'!WIDft' 113311 8- It, I~ll., n. U!l42
813-780-0020 r1X1813-780-0021
--~ J
PAJlCU 10 t
WORK PROPSEDI Chaw ~STlI.UCTION
DSIGN
OWNER' S llA)li:
-'OIl 1.ZlDUII .37
LEGAL DESCRI PTION:
f"Yl.4 (\j <9 ({
o ADDITION
b NOW
ClALTERATION
Cl D2HOLISB
o DlSTALL
PROPOSED OSE: OSGL FAMILY DWELLlNO
o COIol(EP.CIAL
OWULTlwr>>sILY
.0 INDUSTRIAL
0, OF ONI'1'B
o SWIMMING POOL
o MOBILE ROHI.
D~
OTHER
BOILDING SIZE
SQOAU FOOTAGE
HEICRT
Da'CSUPTION OJ' WOIUC
r::::J JU:81'ADlWl'r , 8ULT" I;)E'AJ\'1'HENT APPROVAL /
pQJVt()~ -rfUdJltt<e q 'I :,.J~J S S;u" ~/2e
aESIDENTIAL: ATTACH (2) PLOT ,~s , (21 lETS or BuILDING .tANs , (1) SET ENERGY PORHS,
COt9!ERCIAl.: ATTACH (31 SETB or 'BOlLOING 'LANS , (11 BEt &)liIlQY FORMS.
IF SIGN PERMIT ONLY l~) SETS or ZHGINZtkED 'LANS'aEQUI~.
PROPERty SURVEY REQOIRJ:D roR ALL )lP COWSTRDCTION.
PUMr!'S DQUES'lKD
o tLECTI'.ICAL
o PL~ING
o HECHA.l/lCAL
,
AMP SUVICI
o Proqz:eu Enerqy 0
N.R.Z.C.
VPt u:
:\\ c; ;).()S
o aOILDING
,
VALOA'l'ION or fO!AL CON8Tl\OCTION
,
VALUATION or t4CllANCIAL INSTALLM,'ION
~-
o GAS 0 ROOfING 0 SPECIAL'n' 0 OTHER
T'YPt or CONSTROCTlOO: 0 BLOCK
rINISHED FLOOR ELEVATIONS
o FWQ;
o STEEL
'0 OTHER
IS . PROJECT III FLOOD ZONE AREA Cl YEll
o NO
fTtkd. w .1\\" r'Y\anJr,
.INc.
WIU)D.
S I GHA TO RJ:
COMPANY
. STAn Co.! 01 IUlGIST t, C3 c.o \ ~ '3 ~
.............~...*.***..~.**.*....................*.***0'
&l.aCTR..! C :>.N
COM'ANY
,
SIGNATU~
STATI CERT OR REGIST t
_.................................................*...............
P1.QrIW\
SIGNATU?.!
COMPANY'
STATE CER'l' 01 REGIST f
..........................................................-..-....
~CA.L
COHPMlY
SIGHATU:U:
StAff: CEJlT OR lEGIS" .
,.**..........*..~*..*..................*.*.~~.!.....*-..........
0'fHD
COHPANV
r,
SIGNl'ITC:::Z
STAT! CERT OK REGIS? .
Vt,f!U4ILUU4/MuN U4: Ub rM LlPIi'rKdl~ jjl,)ILlJJM., HA IH. bJj-/bU-UULJ r. UUJ
CI'l'Y OF ZEPHYlUIII.L8 Pi:RMI'l' APPLIc::ATION
WILDING ~PAJt'rNKN'l' 5335 en at, Jephyrbi 11 a , ])~_3:::~n '1 I, (/ / t1 C
813-780-0020 ~:B13-780-0021 n~~ ~w...~ ~L1'~~
PROD tx:mAC'r FOa PUtUftIW ~ /3 - CJc1 (p..J1CJ~ S-
OONE.' S ..... [: J)wPrtfd +L.oi s ><U:<kr:? '-' 'lfJ .J P - x)31 (/?~~N
JOIlADDuss37'i3J B{Itc..k~te/l"'1 GI Ze..P \,f<-h,ILsrL 3~2-
. . . I .
LEGAl. DESCRIE'TION: LO't(Sl 33 BLOCK SUBDIVISION uJed~wC>a-"b r-nA-N(9 fl..
PARCEL ID t , 0 - ~ -)../ "D/:20.- tX)t)aJ -03':3 C) 'OBUIN MlOM PROPfl:R'l'Y "AX NO'l'T ~fl: I
WORK PROPSEDI DNEW CONSTII.UC1'ION 0 ADDITION DlU.Ti:RATION ){REPAIR OINS'1'lU.L
DSIGN
iJ NOW
o DEHOLISB
PROPOSED OSE:OSGL rAMILY DWELLING
o COMNEaCIAL
(]WULTl-FAMILY
o IblDUSTRIlU.
0, or ONITS
o SWIMMING POOL
(] MOBILE ROME
(] OTHER
...CllIPTIClN 01' WOaK
o RE8TAURAN'r (, IIWTH DEPARTMENT APpROVAL
(2.QJVlOlJ.{2, -t-rGefJl/ke.. q II ;,J(jJ S
BUILDING SIZE
SQUAU FOOTAGE
S;"ZG/~'2e
,
HEIGST . j.)
, (1) SET ENERGY FORMS, ~
roRMS. ~
/2u. b ~JT
aESIDi:NTIlU.: ATTACH (2) PLOT p~s , (2) SETS or BUILDING PLANS
COHHERCIAL: ATTACH (3) SETS OF.BUILDING PLANS (, (1) SET ENERGY
IF SIGN PERMIT ONLY (2) S~TS or ENGINEEAED PLANS. REQUIRED.
PROPERTY SURVEY REQUIRED roa ALL NEW COWSTRUCTION.
PDMI!rS RBQU!lSTKD
o ELECtRICAL
o PLUHElING
o HECHANICAL
,
AMP SERVICE
o Progress Energy 0
tf.R.E,C,
VA-' lA-€.-
~ CjJ ~()S
o BUILOING
,
VALUATION or ~OTAL CONSTRUCTION
,
VAt,UJ\TION OF tUClIANCIlU. INSTALLATION
o OTDER.
....-
o GAS 0 ROOFING 0 SPECIALTY
TYPE OF CONS1I\UCTION: 0 BLOCK
o FRAME
o 9'1 &:ilL
o OTHER.
FINISHED FLOOR ELEVATIONS
IS . PROJECT IN FLOOD ZONE AREAD YES
(] NO
A-l~&. tA) .1\\,\ r'\'\a.nJr.,
./Nc.
SIGNA1'UPJ!:
J . . t:. COMPANY
. ~.)Yl. - ~ STATE CEIlT OR RIlSIST I. C3 Go \ d.-S '3 ~
.~...~...........o.....o~o..**.......~*~...*o.**..*.~*.0.
IIOUDU
S!.IIC1'Rl C IAN
COMPANY
,
SIGNATUR.\:
STATE CERT OR REGIST 1
...............................**....***.........*******..........
~
COMPANY'
5IGNA1'UF.E
STATE CERT oa REGIST f
....*.~._.................**.*..***.......**.w..*...........*.....
NZCHI\NI CAL
COMPANY
SIGNATURE
STATE CEIlT OR. REGIST .
.......................................................**........
MHZJl
COMPANY
c.
SIGNA TORE
STAT! CERT OR REGIST t
OCT/04/2004/~ON 04:08 PM ZEPHYRHILLS BUILDING
FAX No, 813-780-0021
p, 002
A. NOTICE OF Di:ED RESTRICTIONS
The undersigned understanda tha.t this permit llUly be subject to "deed restriction,," which
may be mOre restrictive than City requlations. The undersigned 8s8umes respon8~bility for
cOMpliance with any applicable deed restrictions.
B. 'UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITItS
It the ownar has hired a contractor or contraotors to undertake work, 'they may be required
to be licensed in accordance with state and local requlation". If the contractor is not
lioensed as required by law, both the owner and oontractor may be cited for a misdemeanor
violation under state law. If the.owner or intended contractor are uncerta1n as to what
licensing requirements may apply for the intended work, they are advised to contsct the
City of Zephyrhills Building Department, 813-780-0020.
Furthermore, if the owner has hired a cOntractor or contractors, he is advised to have the
contractor(s) sign po~tions of the "Contractor SeotionsN of this application for which they
will be responsible. It you. as the owner siqns a8 the contractor, you are indicating thet
you, rather than the contractor, are responsible tor the work. .It the contractor wishee
you to sign as contractor that may bean indio.~ion that' he is not properly licensed and is
not entitled to permitt1ng privileges in the C1ty or Zephyrhills.
C. TRANSPORTATION IKPACT FiiS AND UTILITY CONNECTION FEES
D. CONSTROCTUION LIEN LAN (CliAP'l'tR 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, thQ applicant, haye be.n provided with a copy.of .Flor1da's Construction
lien taw - Homeowner'a.Protection Guide" propared by the rloriCla Department of Aqriculturll
and Consuraer Affain. If the applicant is eOlll8one other that the "owner", I cerify that I
have obtained a copy or the above deeoribed document and promise in qood taith to deliver
it to the .owner" prior to cOll\lllencement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that .11 the infor~tion in this application is accurate and that all work will
be done 1n compliance with all applicable laws regulating construction, zoninq, and land
developnent.
Appli~ation is hereby made to obtain a permit to do work and instaliation as 1ndicated. I
certify that no work or installation has oommenced prior to issuahoe ot a permit and that
all work w1ll be PQr!orm9d to m..t standards of all laws requlating construction, City
codes, zoninQ re<;/ulations, and land. developlllerit regulations in the juriSdiotion. I also
certify that Iunder~tand that the requlat10ns of other governnental aqencie. may apply to
the intended work, and that it is my re8ponsibility to ident1ty wn.t actions I must take to
be in compliance. Such agencies include but are not limited to: .Department ot
EnVironmental Regulation-CyprQSc Sayheads. Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment
"Southwest Florida Water Management District-Wella, Cypress Bayheads, Wetland Areas,
Alterinq Watercourses
.Army Corps of Engineers-Seawalls. Docks, Naviqable Waterways
*Department or Kealth , Rehabilitative Services, Invironmental Health Cnit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill IIlAterial ia to be used in Flood Zone "AN or ~A,etc.H, it is
understood that a drainage plan address1ng a .oompensating volumeH will be submitted which
is prepared by a protessional engineer registered in the State ot Florida prior to permit
issuance.
A permit issued sball.be construed to be a 11cense to proceed with the work and not as
authority to violate, cancel, a,lter, or set aside any provision:!! ot the technical codes,
nor shall issuance ot a permit prevent the Buildinq Offioial from thereafter requiring a
correct10n of errors in plans, construction, or violations ot any code. Ivery permit
issued shall became invalid unless the work author1zed by such permit is commenced within
six ~nths ot issuance. or if work authorized by the permit i8 suspended or abandoned tor 'a
period of six months after the t~e.the work is commenced. One 90'"day extension of time
may be allowed tor the permit with fee charge of $15.00. The extension shall be requested
in writinq to 'the Building Official. An approved 1nspection must be log<;/ed durinq each six
month per10d, or the project will be COnsidered abandoned.
~ING TO OWN&R: YOOR rAILOR! TO AECOaO A NOTICE OF COMMENCEMENT HAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE R!;COROING YOUR NOTICE OF COMMZ;NCUitNT. JOBS UNDER
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A ~NOTICE OF QOHHENCENENTN.
Sfd~';;;,J1:: V SIGNAroRE, ",,,...,ro.
STATE OF FLOR
COONTl" Of"
The !oreqoinq
Sefo me this
by
~ (name. of person acknOWledged)
ho 1s personally known to me, or
who has produced
STATE OF FLORIDA
COUNTY or
The toregoing instrument was acknowledged
Before me this ---Pay of , 20_
by
(name of person aOknowledged)
~ho is personally known to me, or
Owho has produced
(type ot identification)
and who Odid D:1id not take an oath
Signature of person taking acknowledgment
Name
typgd, pr~~C'A ['5NAf~ON
NOTARY PUBLIC. STATE OF FLORIDA
COMMISSION # 00044518
EXPIRES 9/1712005
BONDEDTHRU 1-888-NOTARYt
Name typed, printed or 8~amp.d
11!1U1I illII ~I
Thili inlitrurnent Prepared by:
Name: . SEARS HOME IMPROVEMENT PRODUCTS, INC.
P.O. BOX 522290
1.0NGWQOO, FI. 327~-~lXl
HQ7-55H1376
111111111111111111111111111111111111111111111111111111111111
2005029262
~.
~.
1.
NOllCE OF COMMENCEMENT
,~Z:~;~J~ .
~ PrtSco
I ... V
THE UNDERSIGNED hereby give!, notice that improvement will
be made to certain real property, and in accordance with
Chapter 713, Floridll Statutes, the foUowing information is
provided in this notice of Commencement,
P,4/2..c-eL.XU I () - 2G - ~ /- {J 1::2...0 .-6 GGCG
Description Qfproperty: (legal description of
property. and street address if available). ,
37L/L{J /314<-kf5elZP-y c:/ 2'~Ph1(<h,(IS FL 53C:;Y~
~..)..f'&~\.t.)OO{'~ mA~()(?_ Phc.SG- (>r-~ -PS ~ ( I~ II-ji.{ Lot33 1:112....3'16'(
. . PEr 5Y{O
State;
Rcpt.:856145
DS: 0.00
02/16/05
ASCO COUNTY CLERK
~!/~~~~~~2 ~G 1377
Rec: 10.00
IT: 0.00
_____ Dpty Clerk
CQU\lty:
C33G
2.
G(:neral ~escription of improvements: pv ,.;)~
l-..... ,iVrl(Jl< . l~pi('Ht::..{Yl~NI
3.
Owner information
a. Name and address:
tiw-J
,S! 6 /, c/, -I." i
'J 7 ytjJ
/1/~~. vi" . .. .
. . . o/lJl/r J (jJ-YL
b. Interest in property:
"'tl"'~
c. Name and address of fee simple titleholder (if other than owner);
4.
5.
S~ty
a. Nam
SEARS HOME IMPRQVEMENT PRODUCTS, INC.
P.O, :SOX 522290, LONGWOOD, FL 32752.2290 1-8()()"2Z2-S030
NA
b.
Amount of bond
$
6.
Lender: (name & address)
NA
7.Person~ within the S~te ofPlorida designated by Owper "pon whom notic;:eliQr other do~umcrnts may be
;;erved ~ provided by St;:ction 713, 13(I)(a)7, Florida Statutes: (name and addre$s)
r ~. . . .
a. In addition to himself. Owner designat!;S the following person(s) toreceivCf a copy oftht;: Lil;nor's Notice as .
providt;:d ill Section 713.13(1)(b), Florida Statutes: (name and address)
ABOVE NAMED CONTRACTOR
9. EJl:piration da~e of Notice ofColllmencement (the expiration date is 1 year frQJll the date ofrQcording unless
a differcrnt te is specified)
,
-"
(Signature of Ow r
Drivl;rsLicense#: 5tf,z .J-p(J2 . :?il-t'2.3 - f)
aw.,,,', N"",,, dw.wj L' S J. /, . rJ,:/.;,! E) uxt J(p 5 ch I; ch-l-i ~
Owner'sAddress: ~2 ,.ft!.) 4it-/c-t- ?~j/I/>-- /73,.rY '--<
All infonnation must be typed or printed legibly to comply with recording requirements.
. STATE OF FLORIDA /J.. .'] ... .
COUNTY OF ...~. . r4&n .
// ...... .....
The foregoing instrumeut >,vas ackn~wledged before me th~ ~ ,pfJ by 4~ t. ..~ t, i~;~5?
who is personally known to m~ or has prod"ced ..{) ,( ~I,lS identification and who did .
(did not) take an oat
(Signature of person taking acknowledgement)
. My Commission 00160644
expires December
(Name of officl;r takiitgacknowledgement . typed, printed or stamped)
(Title OJ;' rank)
. M9. Rev. 08/03
(Serial number, if any)
~ Location: /e. '1"'"' /....
Phone #: T;Q ~ ..151 ' 9/ t;??
Job#: ~:s-~,:)-~
. .~ </0<
./ Replacement Wlndows.3'/:J -,3 ..J - 2. S- J 7
Name &}tAJe-".,J -+- ?h, 'J' .5 ~ /,,-c/. -f..-n, Phone: Res: ~~ .....~ Bus.
Address:-:J'7l/f.{3 4~~~ Gr. City: /~%~J:.II~_s,~?(
I/We. the owners of the premises described below. hereinafter referred to as "Purchaser" offer to contract with Sears Home Improvement Products
hereinafter referred to as "Contractor", to furnish, deliver. and arrange for installation of all materials necessary to improve the premises located at.
~~L-" (City) (State) .-.-.---- n(Zip)'
According to the following specifications:
,. Remove existing units to be replaced. (NOTE: Removed units are likely to be damaged.)
2. Prepare openings as necessary 10 receive replacement units.
(No finish work other than normal Install I n Is to be done unless otherwise noted below.)
3. In"t,,1I SO"", Woatherbeater Windows In openings described below to the following specifications:
Sears Home Improvement Products, Inc.
License No. CB C039161
P.O. Box 522290 + LongwoO<f. FL 32752.2200
Zln: ::3 .::J~-l.J L
Color:
Type:
~i!e. D Tan
~H
Qty .2
rn EE EB 1-.101-10
DSH
D White/Light Woodgrain Interior 0 White/Dark Woodgr
m-LR D3-LR -.U PW Othe
Oty....c:. - Oty_ Oty_ olyL
Oty_
~
o Other
Qty_
o Clear 0 Bronze D OBS '~ Qty_
4'-ow E'/Argon 0 Gray D OBS Full Qty_
o Tempered Oty __ 0 Keepsafe Ql)i_
NOTE: Tem~ered glass will be installed to meet bull~.g codes.
~eo.s.; CHECK IF OTHER THAN FI~L.AS.S;
(On 5<<1;11.." Only) 0 Alum
~
Yes [B"'"
No 0
COI Sculp Col Flat
Diamond
Top
o
F~
Bonom
o
White
Tan
Wd Grain
Brass
Warranty: Manufacturer's Warranty sent upon completion.
4. Existing units NOT to be replaced: .4~
..._____1 ~~o(
."
, /
5. If applicable, after completion of project. the application and removal (storage) of shutter panels shall bc the responsibility of the purchascr. In th.?J
event the project requires the Installation of storm shutters or egress windows. Contractor will not re-install any effected security bars. I >fIIff #
6. Special Instructions: 4~-
7. Clean up job related debris and provide necessary permits and insurance.
8. If applicable. In the event that Contractor Is unable for whatever reason to obtain the proper permits prior to the commencement of any work.
Contractor shall refund any previous payment and this transaction shall be automatically cancelled.
9. Allow approximately 3-6 weeks for installation.
I NOTE: THE WARRANTY PR~VISIONS AS STATED ON THE REVERSE HAVE BEEN EXPLAINED AND IIWE UNDERSTAND THEM FULLY 1
~,?,?mONAL PROVJSI~.NS J\~~_~~~ANTI':~_ ARE STATED ON THE REVERSE SIDE AND ARE A PAftT~r= TH.IS .~.~NTRACT. JJJ
Please read the following bold type and initial corresponding line.
Verbal understandings and agreements with representative shall not b'e binding. All understandings and agr.em~ust be set forth In
writing in this Contract. Due to climatic conditions, Interior condensation may occur. Purchaser InitialS: I ~ _ I
$ '7,:?p ~
Terma: Credit
Cash
Balance Payable
o (Subject to the approval of the Credit Department)
o (Final Payment payable to Inataller upon completion) Funded by:
$ <}#/ ~..r .00
$ .00
$ 92.." ..s- .00
Contract Price
The TOTAL PRICE for all Labor & Materials (including any applicable discount) is
Down Payment
State Sales Tax (_ %) $
(II applicable) $ CI .-
Total Contract Price $ / 2...p ~ .
Bank:
C~ ~.
A=t#
1D% Pref..,.ed Customer Discount (PCD) awarded for .ny future Sear. Home Improvement Products purcha.... Current pricing available for one (1) year.
II this is a credit transaction. the agreement for credit is contained in a separate document whiCh is incorporated herein by reference and made a pan
hereof. INoIe the undersigned are hereby authorizing Sears Home Improvement Products, Inc. to verify and review my/our credit record with an independent
credit reporting agency and relAARA them from all liability incurred from inadvertent omissions or errors~ J J
IN WITNESS WHEREOF Purchaser(s) have hereunto signed their name(s) this ./c7 day of /"~ . 20~and acknowledge
receipt of a true copy of this Contract and unless otherwise specified. it is understood that the owner Is ready for work to begin.
THIS MESSAGE APPLIES TO DOOR-TO-DOOR SALES ONLY: You the Purchaser(s) may cancel this transaction any time
prior to midnight of the third day after the date of this transaction. See accompanying notice of cancellation form for an
explanation of this right.
Stgna1ure affhced below acts as receipt that Purchaser(s) received separate cancellation forms.
Date
O.2_;d,e t>;~
Dale
~ 0 --t1S'
Dale
.~~.
E2.S0 07/04
d -:.Li2 /0 s- WINDOW PRO.POSAL WORKSHEET ~~
n :!..~7 ~_ 2-:-::_~~=-~ 7 Office Loc. and #; ~ ~J - ~J.
S c.h L... ,-I.. +,,,, ~ Sales Rep; c.5~-.i< r; 7 ______________
o/-~.1'-Ji~-------------------------- Job No./Lead No.: ~ ~ "7 J-.J ~-::.I:. ____
-
1111111 IIII11III ~
A/."l"4Lo O. -:r-~ a.nJ
t:? ~ Y 7 .s-:J 1/ if CO :J..p.:J ~17 ~
I 37i-. 0-"
i$/EARs
MOM&' IM"'Cf\~- ~"'1:<lJ:--'
Date:
Phone:
Customer:
City;
ENTER WIDTH & HEIGHT
FOR EACH UNIT TO BE
REPLACED AND ENTER
CORRESPONDING NUMBER
WD HT we HT
rngt:t~6:t-~ BE
;;
HT
WD
#
#
LEFT
/(. BAC ~
,....
~
~
14
.
Series ~ ____
;) .<. FIitONT
~HT W1HT
___ . ___..~7 # .LEjE
For second story - use additional worksheet
we
#
#
HT
x
X
ITEM MODEt... COLOR U.1. GLASS SCREEN GRID TEMP/OBS I
1 ~ )/1 tv ./'p LZ. ~ C.r: '-
2 7' 1M Jv G A'z y c~
-
3 ~ rI w p r-Z /< C-r ~ I
4 n ~ /A.J /"p 2- jIf-4.. I- /~ -
5 fdl- ~ {;v /2:J -6 <. / ( .~ --
p; I~LK /ZJ ~2 -~ r ~
tv -
7 VJrJ Vv q3 ~( // rrL
--
8 ~r; /A/ 90- ,('!'" 7 ....- {'/'- -- I
9 ~~H l/"J 9if A'l. (....r -
~Q ./)/) tV L '/.9 .?.z... ~ L"F -
11 r I
12 I Ir,l"/A .:l
13 dt"/t? , L....L ~/(.
14
15 H-
16
17
18 ..
Detail additional labor and charges:
I
I
I
I
SPECIAL INSgCTIONS;
6r,- rffi- ~:;,;t~b ~~;j;~::! ~p-CJ:;:::b1:';t,$;7: ,'C1J I
Bays/Bows: Specify window type (Ie, casement DH. elc.)
Auditing Manager I
I
J
II
~
OFFICE USE ONLY
RATE:____~________
SALES MANAGER APPROVAL
X
X
RIGHT
#
#
#
#
#
#-
MODEL
PO Patio Door
DH Double Huna
2LR Two-Lite Roller
EV Three-Lite Roller
PW Piclure
SH Sinele Hune
1LR Sin"ale Slider
CR __Q~!1l~_me_r:!!B!fl.~
CL Casement Left
AWN Awnina
HOP HODDer
GW Garden Window
BAY Bav
BOW Bow
COLOR:
White
Tan
LWG L1aht Woodarain
DWG Dark Woodarain
GLASS:
CLE Clear
Hv-LIle Block
E2 Low ElSouare
GRAY Grav Tint
BRZ Bronze
OBS Obscure
OBSBOT Obs. Bottom
KEEP KeeDsafe
TEMP TemDered
GRIDS:
CF ColQnial.FuJl
CT, Colonial Too
DF Diamond Full
DT Diamond Ton
SCULP Sculotured
PER Perimeter
PRA Pralree
SCREENS:
FULL OR HALF
ALUM.
MISCe"LLANEOUS
MULL Mullions
CAP Cap Facing
~->
>
-->
->
~)
PROJECT NAME
SCHLICHTING
PROJECT ADDRESS 37443 BLACKBERRY CT
SEARS PROJECT # 4295356A
STATE OF FL
-
PRODUCT APPROVAL
CATEGORY SUB CATEGORY MANUFACTURER NUMBER
EXTERIOR DOORS SLIDING SIMONTON FL184
WINDOWS DOUBLE HUNG SIMONTON FL143
WINDOWS HORIZONTAL SLIDERS (2LR) SIMONTON FL203
PLEASE NOTE:
ALL WINDOWS HAVE AAMA APPROVAL WITH DESIGN PRESSURE ON THE WINDOW