HomeMy WebLinkAbout10-10941 i
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 10941
BUILDING PERMIT
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Permit Number: 10941 Address: 38545 5TH AVE HISTORIC ;s" • 9
Permit Type: RE -ROOF ZEPHYRHILLS, FL.
Class of Work: ROOF REPLACEMENT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11- 26 -21- 0010- 15100 -0140
Im rov. Cost: 1,340.00
Date Issued: 9/20/2010 Name: CITY OF ZEPHYRHILLS
Total Fees: 50.00 Address: 38545 5TH AVE - HISTORIC
Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542
Date Paid: 9/20/2010 Phone:
Work Desc: REROOF RUBBER - WOMENS CLUB -APP PER HISTORIC BEV HAS PAPER WORK 9/20/1
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REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to any one of the following reasons: a) wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections 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.
NOTICE: In addition to the requirements of this permit, there may be 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.
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 recordin . your notice of commencement."
CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION — 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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ZEPHYRHILLS HISTORIC PRESERVATION BOARD MINUTES
A Historic Preservation Board Meeting was held on Tuesday, September 7, 2010, in the
conference room att the Municipal Building at 5:00 P.M. Chairman Geiger called the meeting to
order 5:05 p.m. as a quorum was present. Roll call was taken. Present were members Jason
Aiken, John Geiger, and Tracy Sullivan. Bill Back was unable to attend. Staff present was
Todd Vande Berg, Director of Developmental Services.. A motion was made by Tracy Sullivan
to approve the minutes as presented from the January 26, 2010 meeting. Motion was seconded
by Jason Aiken. Motion passed unanimously.
New Business
1. & 2. Application for a Historic District "Certificate of Appropriateness" submitted by Ronald G.
Pentaude at 38617 — 6 Avenue. and Application for Facade Improvement Matching Grant
Application submitted by Ronald G. Pentaude at 38617 — 6 Avenue.
Mr. Vande Berg verified that Mr. Pentaude's house is a contributing structure in the
Historical District. The Board reviewed the work he wants to do, the pictures of the materials he
is proposing to use as replacements, and the pictures submitted showing the deteriorating parts
of the home. It was discussed that he wants to do most of the work himself and that he knows
that he will not be eligible for grant reimbursement unless a certified contractor does the work.
Chairman Geiger suggested that they should approve the Certificate of Appropriateness for the
work he wants done and at this time approve the termite work for the grant reimbursement until
he gets the contractor's estimates for the electrical and painting. Everyone agreed with his
suggestion and Jason Aiken moved to approve Mr. Penaude's grant application for 50%
reimbursement for the termite treatments and also approval of the COA's submitted for the
work he wants done except for the electrical upgrades and the painting of the exterior which he
will get contractor's estimates. Motion seconded by Tracy Sullivan. Motion passed
unanimously.
3. Application for a Historic District "Certificate of Appropriateness" submitted by Woman's
Club of Zephyrhills at 38702 8 Avenue. and Application for Facade Improvement Matching
Grant Application submitted by Woman's Club of Zephvrhills at 38702 8 Avenue.
Staff explained that this building is a contributing structure in our Historical District, it is
City -owned and the Woman's Club has a Lease agreement for 99- years. It was discussed that
the Woman's Club's roof was over 20 years old and they paid for repairs in 2009 but it is getting
beyond repairing. The Club has been told that Facade Improvement Grants were initially meant
for residential homes but because they are not a commercial establishment they have
requested consideration and possibly an exception. Mr. Vande Berg explained that there are
unused monies in the budget for this year and it will not be carried over, ultimately no one
knows if there will be funds budgeted for next fiscal year.
After discussion, the Board agreed by consensus of opinion that they felt it was not
appropriate for them to recommend approval since it is not a residential structure.
Meeting was adjourned at 5:30 p.m.
Jacqueline Boges
To: Beverly Jones
Subject: Need the approval for women club
Hey Bev,
I am still in need of the woman club approval minutes for the reroof. 38545 5 ave
thanks
Jackie Boges
Code Support Specialist
ext. 3513
1
813- 780 -0020 City of Zephyrhills Permit Application Fax -813- 780 -0021
Building Department
Date Received / Phone Contact for Permitting —
Owner's Name 2 1thLt 1410/t-Zn/t/J CGca, Owner Phone Number
Owner's Address 3 YS-9S S AEG Owner Phone Number
Fee Simple Titleholder Name . Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS 3 ps9S ,5 f'JG 3 (uy e
Lo //
SUBDIVISION PARCEL ID# — - do /p /5 / (WO
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADD /ALT I I SIGN I I I. I DEMOLISH
INSTALL REPAIR
PROPOSED USE I I SFR I1 COMM 1 1 OTHER I
TYPE OF CONSTRUCTION 1 I �f}' BLOCK I—I FRAME I I STEEL 1 I I i
DESCRIPTION OF WORK t 00//;t4
BUILDING SIZE SQ FOOTAGE HEIGHT
(BUILDING $ 1 3 � 0D ', VALUATION OF TOTAL CONSTRUCTION
I (ELECTRICAL $ / AMP SERVICE I I PROGRESS ENERGY I I W.R.E.C.
(PLUMBING $
IMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
IGAS �t� ROOFING ri SPECIALTY I 1 OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IYES NO
BUILDER COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURREN I Y/ N I
Address License #
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y/ N j FEE CURREN I Y/ N I .
Address License #
PLUMBER COMPANY
SIGNATURE REGISTERED I Y N I FEE CURREN I Y/ Ni I
Address License # I
MECHANICAL COMPANY
SIGNATURE REGISTERED I Y / N . 1 FEE CURREN I Y/ N 1
Address , O License # I
OTHER ` ` COMPANY (Y/J7/ //✓ i tBefm:JG'
SIGNATURE REGISTERED I Y/ N I FEE CURREN I Y/ N I
Address , PO £01/41- )36) QC, zL 3 3 fa License# jet D Dy� zy
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 Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects
COMMERCIAL Attach (3) 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, Stormwater 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 $2500, 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 (Front of Application Only)
Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey /Footage)
Driveways -Not over Counter if on public roadways..needs ROW
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 prior 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 prior to permit issuance. Furthermore, if Pasco County Water /Sewer Impact
fees are due, they must be paid prior to permit 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 I, the applicant, have been provided with a copy of the "Florida Construction Lien Law — Homeowner's
Protection Guide" prepared by the Florida 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. 1 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 "V" 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 stem wall.
- 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.
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.
FLORIDA JURAT (F.S. 117.03) L i�:'L
OWNER OR AGENT CONTRACTOR
Subscribed and sworn to (or affirmed) before me this Subscribed and sworn to (or affirmed) before me this s
by by
Who is /are personally known to me or has/have produced Who is /are personally known to me or has/have produced
a identification.
Notary Public Notary Public
Commission No. Commission No.
Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped
MIA M MADE M kM I-DADE COUNTY, FLORIDA
_ METRO -DADE FLAG ER BUILDING
BUILDING CODE COMPLIANCE LANCE OFFICE (BCCO) 14$ WEST FLAGLER STREET, SUITE 1603
PRODUCT CONTROL DIVISION MIAMI. FLORIDA 33130 - 1563
(305) 375 -2901 FAX (305) 375 -2908
NOTICE OF ACCEPTANCE (NOA)
Union Corrugating Company LLB, @` <
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P.O. Box 229 REVIEW DATE - ' ' " �I ,,.�
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Fayetteville, NC 28302 CITY OF ZE r�H�• ,;gym ;
HI
SCOPE:
PLANS EXAMINER - �,
This NOA is being issued under the applicable rules and regulations mg the use of canatructiou materials.
The documentation submitted has been reviewed by Miami -Dade County Product Cantrd Division and accepted
by the Board of Rules and Appeals (BORA) to be used in Miami Dade County and other areas where allowed by
the Authority Having Jurisdiction (AM).
This NOA shall not be valid after the expiration date stated below. The Miami-Deck County Product Control
Division (In Miami Dade County) and/or the AHJ (m areas other than Miami Dade County) reserve the right to
have this product or material tested for quality assurance purposes. If this product or material fads to perform in
the accepted manner, the n1 1u6 Curer will incur the expense of such testing and the AHJ nary immediately
revoke, modify, or suspend the use of such product or aerial within their jurisdiction. BORA reae:res the right
to revoke this acceptance, if it is determined by Miami-Dade County Product Control Division that this product or
material fails to net the requirements of the applicable building code.
This product is approved as described herein, and has been designed to comply with the High Velocity Hurricane
Zone of the Florida Building Code.
DESCRIPTION: 5V Metal Roof Panel
LABELING: Each panel shall bear a permanent label with the ms's in or logo, city, state and the
following statement: 'Miami-Dade County Product Control Approved', unless otherwise noted herein.
RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no
change in the applicable building code negatively affecting the performance of this product.
TERMINATION of this NOA will occur after the expiration date or if there has bear a revision or ewe in the
materials, use, and/or nee of the product or process. Misuse of this NOA as an eardoraement of any
product, for sales, advatis iug or any other purposes shall automatically tesmiaate this NOA Failure to comply
with any section of this NOA shall be cause for termination and removal of NOA.
ADVERTISEMENT: The NOA number preceded by the wards Iii -Dade County, P7arida, and followed by
the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, theca it shall
be done in its entirety.
INSPECTION: A copy of this =tire NOA shall be provided to the user by the manufacturer or its distributors
and shall be available for inspection at the job site at the request of the Building Official.
This NOA revises and renews NOA * 05-0919.07 and cots of pages 1 through 7.
The submitted won was reviewed by Alex Tigers.
-fr ( 7 411114.--
NOA No.: 06-102.13
Milked= Date 06J17/12
Approval Daft» Oi114107
r , rage 1 of 7
•
ROOFING ASSEMBLY APPROVAL:
Cateeotti: Roofing
Sub -Cam: Neal Metal Roofing
Material: Steel
Deck Tyne: Wood
Matbwa Desna Pressure -120.9 psf (See General Imitation #1)
Fire fagiglcaO Pressure See Geaerai Ikon #2
TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT:
Di ons Test Product
So DesariDtioa
5V Metal Roof Length: varies TAS 125 Metal Roof panel coated with various
Panel Width: 26" approved coatings of Ceram-A-Star®
(Coverage width : 24") 900.
Height W'
Mm. Thickness 0.019"
TRADE NAMES OF PRODUC'ZS MANUFACTURED BY OTHBRS:
Dimensions Product Manufacturer
Description
Fasteners #9 Corrosion resistant, sharp point hex- Generic
(Panel) head screws with neoprene sealing (with current
washer. NOA)
Evw z SUB111 ITZD:
Test Atene9 Test Ides►tTdser T est Na®dEenort Date
Farrabaugh T164-06 TAS -125 06/08/06
Engineering and
Testing, Inc.
Al= Nobel Coatings, Lab Test Certification ASTM B -117
Inc. ASTM 0-23
PRIAsphalt HTL001 -01 -01 PA 100 02/18/02
Technologies, Inc.
Hurricane Test 0293 -0202-06 TAS 125 06/05/06
Laboratory, Inc.
Hurricane Test 0293-0609 -05 TAS 125 06/22/05
Laboratory, Inc.
NOA No.: 06- 1002.13
Expiration Data 05/17/12
Approval Date: 4/07 of 7
rr
11- 26 -21- 0010 - 15100 -0140 •
Assessed in Section 11 , Township 26 South, Range 21 East
of Pasco County, Florida
ZH MB 1 PG 54 LOTS 14,15 BLK 151 . I IIIIII IIIIIIIIII IIIII IIIIIIIIII IIIIIIIIII IIIII IIIII IIII IIII
__ 2010133317
NOTICE OF COMMENCEMENT Rapt:1326404 Rae: 10.00
DS: 0.00 IT: 0.00
09/17/10 A. Giard, Dpty Clark
Permit No. MLR S.O'NEIL,Ph.O.PRSCO CLERK / � L COMPTROLLER
09 OR BK0 84 PG G 4
Property Identification No.
•
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section
713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT.
1. Description of property (legal description :) d' ' Do
a) Street Address: 3 4 S ?S t r /1-4/6- 69 (//L pL` tL 3 35 - _
2. General description of improvements: te-- Af4104 ✓I- / • /
3. Owner Information
a) Name and address: C l /Pt Z5PAyn, /Lej 5 8 z sr 2.tsora�x/o�/ws ...4,____3,..7,r72_ b) Name and address of simple titleholder (if ther than owner)
1960 c) Interest in property 0 t4/ A/ C-/(
actor Information
a) Name and address: 4.41/44 ✓ ROOt /,6 /PD ,/f O x I 3 DAO6. t^/y f — 33,fS
b) Telephone No.: 3S7t.. S6 7.— 5,93? Fax No. (Opt.) 5,4•1.7 e. Y
5. Surety Information Q z V IY c
a) Name and address: LL U O = ` Lll
b) Amount of Bond: 0
c) Telephone No.: --- Fax No. (Opt.) tq Z U J T s
6. Lender Q O O — N e
a) Name and address: Q W d L n
- �" Phone No. 0 CC 2 Z al
7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: >_ LL t- c _ O. • t
a) Name and address: ' F- LL CC U 0
b) Telephone No.: ,_-,--- Fax No. (Opt.) _ L O O I t
8. In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section w
713.13(1) (b), Florida Statutes: Q Q 0
a) Name and address: Q 1 f-- J ZQ in 3 `
b) Telephone No.: --- Fax No. (Opt.) . Q >- U m n LL 0
9. Expiration date of Not _LL W
' e of Commencement (the expiration date is one year from the date of recording unless a different date is Z O -
Specified): �� �} 0 C e tY t1 --g- r Lii `
O Q Z 1
U.oU >-
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF Q 0 0 c p •
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, 1.1J CO
FLORIDA STATUTES AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. W Cn Q --t W `Z \
A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST Q to D LL z D
INSP IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE I— = tY Z — < }
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. O t1 m
STATE OF FLORIDA
COUNTY OF PASCO .e./llt...
Signature of Owner Authorized Officer/Director/Partner /Manager
3 e P, Tit ;pi
Print Name
foregoing instrument was acknowledged before me this /day of 20 /a, by
as € (type of authority, e.g. officer, trustee, attorney
in fact) for /4, orYintl !e 1.64 Oee 1#14tif rt(S (name of party on behalf of whom instrument was executed).
Personally Known OR Produced Identification Y Notary Signa C
' Type of Identification Produced re, 0 L__ Name (print) C n ■}Aj cL. C. 6 ww
v ". CYNTHIA C GUEST
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, 1 declare tha
Ca - �lb1Ai11lCateitAllyl FhrN1
the facts stated in it are true to the best of my knowledge and belief. ii 's . ' �, re MY Comm. Eepket Ayr 1 29U
1 / ' OP't mleeton • DD 979517
.1. — — ° Balled Through National Notary AUL,
S r'Fature of Natural Person Signing Above
FORMSINOC,rvsd2007
V rop AZai Page No of Pages
L �JVTJ 1
Gavin Roofing
Quality Roofing Since 1984
P.O.Box1364 N� 1056
I Dade City, FL 33526
352- 567 -5034
Lic # RC 0046241 2 Year Leak Warranty
PROPOSAL SUBMITTED TO PHONE DATE
7ari / A Wed' t c:L i-t 6 `2 . / s lD
STREET / JOB NAME
CITY, STA`rE and ZIP CODE JOB LOCATION
2J-,A4v ,94/4L- S '/
ARCHITECT // J DATE OF PLANS JOB PHONE
We hereby submit specifications and estimates for:
` &/E/L ' - -, /6: £oo' 0)eT7/- ,z i All. Se
G%n - ✓n - ti pi /v1 —MLZ , /V U&41 �ii/T No oQ iv, /e
/36 adoA/ hs N T ,Q — / 4 ,9 u
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/ l P Propose hereby to furnish material and labor — complete in accordance with above specif' ati / s, for the sum of:
A14- - rdG Af Tth 47 � 0 k 1 W YJ7 / f) 1--------' dollars ($ f ` Yea, )•
Payment to be made as follows: /
CO /ter d/ 0,c Tog
All material is guaranteed to be as specified. All work to be completed in a workmanlike /�
manner according to standard practices. Any alteration or deviation from above specifications Authorized L
involving extra costs will be executed only upon written orders, and wit become an extra Signature
charge over and above the estimate. 'All agreements contingent upon strikes, accidents
or delays beyond our control. Owner to carry fire, tomado and other necessary insurance. Note: This proposal may be
Our workers are fully covered by Workman's Compensation Insurance. withdrawn by us if not accepted within da y s/�
/ Atrrptanuu of Proposal — The above prices, specifications \\
and conditions are satisfactory and are hereby accepted. You are authorized Signature
to do the work as specified. Payment will be made as outlined above.
Date of Acceptance: Signature
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