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CITY OF SANFORD PERMIT APPLICATION
Permit #: Inc , `, Date:
Job Address: Hog Vj . 2014"n 9-11 _
Description of Work: W(n(An W re Voc_-e eyi-e n « S1Ci IM,e_ SM2l
Historic District: Zoning: Value of Work: $1 r1 e!a'L
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addi tion/A Iteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial
Occupancy Type: Residential Commercial Industrial Total Square Footage:
Construction Type: # of Stories: ##/off Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: 3 U— 101— /3-'i' ` —,(JI — 11500
l (
Attach Proof of Ownership& Legal Description)
Owners Name & Address: -t(l T"I r B o w i i n 1/ 0 W Lo. 2D1+'"' c_:%-1-re1e_+
1 "1 i Phone:
Contractor Name & Address: f V i rren l /!//l
GFU. R /_ I12 Z2 10 / n
n
D Fdt 3Z'77 Z State License Number:
go-7Phone & Fax: y— 475 -n Ll5qd _o.X ContacAAIWV ftpBondingCompany:
Address:
Mortgage Lender:
Address: MAR
r
ArchitectlEngineer: Phone: f: i
Address: left.,.
Application is hereby made to obtain a permit to do the work and installations as indicateEaGi is Ration has commenced prior to the
issuance of a permit and that all work will be performed to meet standards ofall laws reg ' iction. I understand that a separate
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIDAVIT: 1 certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. 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.
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 districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requir cots
jjFFd
Lie
LaSignatureofOwner/Agent to Signaturetra or/A I n Date
Print Owner/Agent's Name P ' Contrac r/Agent's Name
Signature of Notary -State ofFlorlda Date Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
Contractor/Agent is Personally Known to M or
Produced ID
APPLICATION APPROVED BY: Bid e:ll ?y l "Zoning: Utilities:
Initial & Date) (Initial & Date)
Special Conditions:
v
FD:
Initial & Date) (Initial & Date)
CITY OF SANFORD PERMIT APPLICATION
Permit # : Date: Z "J
Job Address: y by 2t)`,*) S-
Description of Work: yxn(An w Ire m -e 1i)
Historic District: Zoning: Value of Work:
Permit Type: Building Electrical
Electrical: New Service — # of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: IN of Water Closets
Occupancy Type: Residential Commercial
Construction Type: # of Stories:
Mechanical Plumbing Fire Sprinkler/Alarm Pool
Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Calc. Required)
of Water & Sewer Lines # of Gas Lines
Plumbing Repair — Residential or Commercial
Industrial Total Square Footage:
of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: ') U— t - I S 11- _7V La -( )L JLJU - 1 JL>lJ (Attach Proof of Ownership & Legal Description)
Bonding Company:
Address:
Mortgage Lender: CA -
Address:
Architect/Engineer: r Phone:
Address: Fax:
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand that a separate
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIDAVIT: 1 certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. 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.
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 districts, state agencies, or federal agencies.
Acceptance of pe it' erif io that ill notify th caner of the property of the requirements of Florida Lien Law, FS 713.
3-ZI-OS
gn ture of Owner/Alfint Date Signature of Contractor/Agent
Kr'141 no. Bowl t v-,
Print Ow /Age is Name Print Contractor/Agent's Name
S
Signature o otaryrate of Flori pt+Y Pus Signature of Notary -State of Florida JEAANJPERTMY
COMMISSION # DD 214830 EXPIRES:
June 16, 2007 s, A
Date
Date
Owner/
Agent is _ Personally 951ot+iodl0 Mr d Thru Budget Notary Services Contractor/Agent is _ Personally Known to Me or T"
Produced
ID ear. _ Produced ID APPLICATION
APPROVED BY: Bldg: Initial &
Date) Special
Conditions: Zoning:
Utilities: FD: Initial &
Date) (Initial & Date) (Initial & Date)
TM. kwoweait r ww- r+
anruo stAMMOue.APF40Y r rPwooti r t. PA:
QODC 6t32Y0: - .. . WNOWpOO:
FL msl O. • . N6.
hcz or.:c6i i iC''WENT State:
Ttts
Urwexs mm hereby gives notice that Imptovemcm will be
trade to certain real property. -and in accordance with Chapter
713. Florida Statutes. the following information is provided
in this notice of Commencement. MARYANNE
MIWI CLERK OF CIRCUIT COURT SEMINOIS
COUNTY BK
05646 PSG 181 I' ,.
CLERK'S # `"S RECORDED
03/ 15/2005 04l; M 40 PM RECORDING
FEES 10.00 RED
BY. L McKinley C.
ERTIFIED[COpl 14ARYANNE
MORSE CLERK
OF CIRCUIT COURT ISEMINOL
LINTY. FLORIDA DEPUTY
ItLOW 1.
Description of property: (legal description of win
pro .and street address if available) - tq -
3 -So " obo o - 117t 1 .5 ZOW. I
s i 15o 1 c571 5eicih413 I 2.
General
description of imptoveateats W1 I L.6 LA-') n I71a -e- me nN 3. Owner tafonnation
A. Natne and
addrssr: r l r, a. 3 d (k11 r, l yn 1 2 C% . ` CL ''' S- b. Intemst to
Ropaty: o_win f 'Y`.tnl 15 rot I r lL 3 27 Z I C. Nameasrdadd:rsoffeesimp-
1idcbo1dcr(ifodrr8ru:iO"0e* c cxffe C.omraesor: (came
andaddress) SEARS ROME DVROV>
OZNTPRODUCTS. INC. P.O.80X5222mLcNawo=
r- .32752-290 14go0-=-5030 5. Surety z
Namc and
address: b. Amount of
bond 6. Lendcr. (name
do address) S NA - HA
7.
Persons
within
the State of Florida desigrnat,;d by Owner upon whom llodees or odter documents may be zc"cd as
provided by Scction 713.13(l)(a)7. Florida Statutes: (name and adtLrss) a. In addition
to himself. Owner designates the following persons) to receive a Copy of the 1lcn0es Notice as provided in Section
713.13(1)(b). Florida Statutes: (name and address) ABOVEWA AED CON'
rRACTOR 9. pirad to
of Notice of CO P=Cement (the capitation date is 1 year from the date of recording ualcss a is ied)
i Drivers Uccitse Owner'
s Name:
Owner's Address: - ,
yQv-e All information must
be typed or printed legibly to comply with recording requirements. STATE OF FWRIDA
COVNTY OF I
r/ The
foregoing instrument
was acknowledged before me+thls l by "If—C A01 (4(Vt4tV` t-. w persooaJly)
wtrwn
to me a has produced . as Identification mod who did di take Signamm
of person
taking acknowledgement) ow 2pL David
R. 60*er Name of officer calcine acknowledgement -typed, printed or stamped) abs; 29400Z (Title
or !auk) I a.
F
jr
PRI
ijr us sVlth
Jame: e.
ob NumOr.
ff-WORKS
6u'5—d
c
VA 3q
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all
Roof HO!Iqrit-
Speed Zone:
fi 1 -7'-
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CO,VA- M64-
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I c 1 2r- 5 Y544 rl, oy
lb 9- 60
frft)j-t
FRONT
0
MQQFl DESIGNATION Simonton Horizontal Slider Series 07-70 / 75-70 Vinyl Window ai
Simonton Horizontal Slider Series 07-75 / 75-75 Vnyl Window W
z
MAXIMUM OVEM L NOMINAL SIZE: Single up to 73' x 51' MASONRY LINTEL
DESIGN PRESSURE RATING : Anchors: Positive 500 PSF Negative 50.0 PSF
2.5"
Windows: Design Pressure Ratings Vary. See FURRING
Corresponding AAMA Test Report or Dade NOA n '•'`
or Florida P.E. Evaluation.
STUCCO
USABLE CONFICURATIONS• XX, OX or XO
L
SILICONE
ENE AI D S .RIPTION The head and side jambs are extruded PVC.
CAULK
DRYWALLThewallthicknessthroughwhichtheanchor1/4 MAX. 1" x 6' 1/4" MAX.
screw penetrates is a minimum of 0.070".
SHIM
SILICONE CAULK
SHIM
HEAD JAMB
3" x 3/16' TAPCON
TYPE ANCHOR
1 25" MIN EMS
DCA5 Gil ,\ :l ULE' #
I' x 2'
FURRING V
DRYWALL u b
Q N
N
r SILICONE CAULK N
r ti .r
od
U .00J" x 3/16' TAPCON
TYPE ANCHOR u c
t71 0 0- Q.
SILICONE
CAULK
STUCCO t7E •'va'•',
HEAD JAMB.' r
41 •'
u .
VERTICAL JAMB,-,
i
2' r 3/15• TAPCON
TYPE ANCHOR
SILICONE CAULK
SILICONECAULK Z
STUCCO
INSIDE STOOL O 2O
SHIM V Z
W
MASONRY I' x 2' FURRING to 3
SILL DRYWALL 1n 0 1n p
0
2.5- —i Z co
SILL CARIBOU LEG SHOWN
O
Cr = UNNCROSSSECTION. O
n OPTIONAL HOOKABOU LEG 2 t`
EXTENSION DETAILED.
1. This system has been evaluated for use In locations edh.,1N to the Florida Buldinq Code
NAxDerOandwherepressurerequirementsasdetermknedbyASC£ 7 Minimum Design Loads for Buildings AM1S. ae
and Other Structures do not exceed the design pressure ratings listed herein. 013.664.J6J1
2. For installations where the sub —buck Is less than 1-1/2' (FSC section 1707.4.4 Anchorage Methods DATE, 4/12/02
and sub —sections 1707.4.4.1 and 1707.4.4.2) Topton lope concrete anchors must M used and the SCALE N.T.S.
length must M such that a minimum 1-1/4' engagement of the Topcon into the mosorvy wall Is obtained. DIM BY: W.L.N.
J. All interior and exterior perimeter surfaces of the window must M caulked. OOL eY: R.W.
4. In the step down application. rill the anchoring screw holes with silicone prior to installing the anchoring screws. OPAWMO NO.:
After the screws are installed. cover eoch screw head with silicone. Ones the screws have been covered with S-102R
silicone; cover the screw access hole with an installation cap or Simonton approved seolont to . WV OF
UOM DESIGNATION! Simonton Casement Series 08-09 Vinyl Window
MAYMAI DyERAi 1 NQUI Al SI r Single up to 36' x 80'
DESX:N PRFSS iR ATIN Anchors: Positive 55.0 PSF Negative 55.0 PSF
Windows: Cosign Pressure RoUngs Voq; See
Corresponding ANldA Test Report or Cade
Nt7A or Florida P.E. Evaluation.
s/esar C rnNF=PAnnuS: X
GE nuf DESCRIPTION., The head and side Jambs oro extruded PVC
The woU thickrwsa•Uvough
which Uw anchor screw penetrotss
Is a minimum of 0.070'.
CAEa FlIF. WA
NOTL
L IEWA
r
LLISLWltY lIME1
FURIZING
S7U000 '...
SIUGONEcuxx DRYWALL
11AX
1' x B'
1/+
Slaty SILICONE l:tUlX
IV '
HEAD DAUB :q
l
1.25' WIN. CUB. '
MASONRY SLOCX
SASH—,w—
oh
cr
eN w
to
p N
C to
Q N
I' it 2' C it rtlLW C00
DRYWALL a a
54 c2oNE C.uax
9 TYPC ANCIKirt `•
TAPCON
N
SASH
1/s• WAX.
SHi"
SIUCONECAULX
SNCCO
R L JAi/ 6 lA+
re- StUCONE
CAULK 2 Slt O =
1
WS" STOOL 8o
SRC=
SHW CENTRAL FLORITDA B.O.A-F in 3 SXL• '
a ?
D
6 MANUFAC TLMExt NAME. MASTER
FILE # 3 cn,
a x S 267IE1
1. This system) has been ewlual••d (or we N 1o0eUa18 G*WL-4 to tho rWWO Bu" Code and
wherw pressure requirements a dol,_*od by ASCE 7 4inl u Desi9n Leads for Busd s and
Other Structures do not -weed the design proasum rwtk gs feted herwln. 2.
7or Lwtoeatians whore uw owl, -buck is Mss •lhon 1-1/2' (f'8C soctlon 1707.4.4 Mrhoro9e Methods euaasre
and
sub-secuons 1707.4.4.1 •end 1707.I.4.2) Topton It," aoncrwts a hors must be mod. and the 011tii43L71 4ngth
must be such That a rnlnimwn 1-1/e' engagement of Vw Topton We the nwoomy "Al 4 ebtokwd. DAM 3/20/. 3.
Miwn going to a smaser window &Us no anrlwr screw shay be In a mortar )olnL 9 a sorer falls 3'.. 1LT.L in
a mortar Joint relocate Ow screw 2.0' above or below the mortar )oL+L IDOM Bn 1!L MMen
tnati;MV a window bsb. 30' lo holght Ow centor screws are s&,ib atvd . WNA Ywtaxup a window 30, to so' CW. M 0.w. inheight
use (1).60" at the frame contr Lw. Mbsn rwtsXkV a window above 60' to 60' in height anchor as shown
w7th (1) screw 3' above and below Ow Gwnd center 6na DilAxeNO I t 061t S. As
Interior and sstoriar perlm•lr surfaced of Uw window lust be
f—
IAODET DMGNATION• Simonton Double Hung Series 75-75/07-75 Vinyl indow
MAXIMUM OVEMI NOMINAL S17F• Single up to 52' x 74' 2
2.25' MIN.—{
DESIGN PRESSURE RATING, Anchors: Positive 55.0 PSF Negative 55.0 PSF LINTEL ' ;
n
Windows: Design Pressure Ratings Vary, See
Corresponding AAMA Test Report or I ,
Dode NOA or Florida P.E. Evaluation.
1SARl F CONEIGf l ATIONS• X
VVNII
X
ENERAI DES .RIP7ION• The head and side jambs are extruded
PVT:. The wall thickness through which
the anchor screw penetrates Is a
minimum of 0.070'.
d
s 6.
s
d
U
Uj v,
LJ
LJ s
y `
S,
ti b
y
9•
aF52.0" MAX. OVERALL FRAME WIDTH
STUCCO
SILICONE _
CA"
1/4- MAX. SHIM
HEADER JAMB —/
INTERIOR
SASH TRACK
RAIL
EXTERIOR
SASH TRACK
HEAD JAMB
1' x 2'
FURRING
DRYWALL
1" x 6'
SILICONE CAULK
3 1/2' r 3/16' TAPCON
TYPE ANCHOR
1.25' MIN.
fir l Y •• n.,•.
7 ; .._• C/`• mot..
1' r 2' ' ,
F FURRING >,;- f o,
A7.ar6'Xd>l.ft
I1
1 a h
ern
MB. 1/4MAX. SHIM Q N . n
N C
SILICONECAULKJ
1/2' 3/16• iAPCON C
N T1?
E ANCHOR r U 00 STUCCO
p
O a O c
U C co 9
VERTICALJAM30
v cn
OIL d SILICONE
SILICONE CAULK CAULKto ZSTUCCO
INSIDE
STOOL 0 Z SHIM
Uj
MASONRY
I' x 2' FURRING h z 3 SILL' DRYWALL N tJ :3a Cr
La CO
7.
625' 1Cti N11,l•T—E -- AY.s F
O x 0 SILL
lY1Hi e1 t' i:'1.. A it i JLL_ r o U ci U Cr IkS
ER FAQ HO •
1. This installation has been evaluated for use in locations adhering to the Florida Building Code and
where pressure requirements as determined by ASCE 7 Minimum Design loads for Buildings and
Other Structures do not exceed the design pressure ratings listed herein. 2.
For installations where the sub -buck is less than 1-1/2' (FBC section 1707.4.4 Anchorage Methods and
sub -sections 1707.4.4.1 and 1707.4.4,2) Topcon type concrete anchors must be used and the length
must be such that a minimum 1-1/4' engagement of the Topcon into the masonry wall is obtained. 3.
All interior and exterior perimeter surfaces of the window must be caulked. 2E=
7-0PATE;
4/27/02 SCALE:
N.T.S. owc.
Ff. TJH CHK.
By., R.W. DRAwer:
N0: 94ET
1 -s i
5-
115
Florida Building Code Online Page I of L
A
The F/orida Department of a mmonity
SBui/dinqCoale-/n,.•formation saystem - i` Y" d " f sr« •"
t, yu a2 , it e%' ; f"'-,fi k,t F f:}''" a
PR0DIJ(;T'APPII0.Y Product SearchOverviewProductSearchOrganizationProduct
Search Application
User: Public User -Not Associated with Organization -
Need [tell) "
Product Simonton Windows
Manufacturer:
Category: Windows I`
Subcategory: g ry:
Application/Seq #:
or ###.#)
Application Status: ALL) ilT•
Evaluation ALL) i4:
Method:
Order by: Manufacturer C Category C Subcategory
C App / Seq # C Status C Evaluation Method
q'.
Page: ---I >' Page 1 /2 Ed
pp/Seq Manufacturer Category Subcategory
Validation
Status
ntit /Validator
FL56 Simonton
Windows Windows Awning Approved
FL57 Simonton
Windows Windows Awning Approved
FL107 Simonton Windows Casement ApprovedWindows
FL108 Simonton
Windows
Windows Projected Approved
F
RI imonton Windows Double Hung Approved
History indows
FL178-
R1
Simonton
Windows Wi doves Fixed Approved
Hi —story
FL179 Simonton Window'ss Fixed Approved
Windows
FL203- Simonton
R1
Windows
Windows Horizontal Slider Approve
Ll_Is —to I
FL204 Simonton Windows s Single Hung Approved
Windows
FL213 Simonton
Windows
Windows Horizontal Slider Approved
FL219 Simonton Windows Single Hung Approved
Windows
FL224 Simonton Windows Casement Approved
Windows
FL226 Simonton Windows Double Hung Approved
Windows
FL228- Simonton
R1
Windows Windows- Fixed Approved
1-listor
FL2339 Simonton Windows Mullions Approved
Windows
FL3061 Simonton Windows ixed pprovedindows
0 F>'r > .,
Page: n, Page 1 12 A p-z•
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v.rtei.
Co eE•cur•d Copyright and Disclaimer 02000 The State of Florida. All rights reserved. %
VE P Fv•
Sears Home improvement Products, Inc. Location:
C
License No. CB C039161 Phone
P.O. Box 522290 Longwood. FL 32752-2290
NUME IPROVEM pR „rts Job #:r
D
Name:Bus.---
Address:
Ci ST t l (J
Replacement Windows
Phone: Res: ...
a{ ( ST City: cz St.: ;? Zip:
I/We, the owners of the premises described below, hereinafter referred to as "Purchaser offer to contract with Sears Horne Improvement Products
hereinafter referred to as "Contractor", to furnish, deliver, and arrange for installation of all materials necessary to improve the premises located at:
Street) (City) (State) (Zip)
According to the following specifications:
1. Remove existing units to be replaced. (NOTE: Removed units are likely to be damaged.)
2. Prepare openings as necessary to receive replacement units.
No finish work other than normal installation is to be done unless otherwise noted below.)
3. Install Sears Wea rbeater Mir Windows in openings described below to the following specifications:
Color: CTWhi e Tan White/Light Woodgrain Interior White/Dark Woodgrain Interior Beige/Dark Woodgrain Interior
Type: H
Qty ,
SH
City`
LR
oty 1'
3-LR PW ther
Oty, City_ Qtya
D Other_
Qty—
O F
Other El Other
Qty— Qty_
Sale Clear C7 Bronze OBS i4 oty` Screens: CHECK IF OTHER THAN FIBERGLASS.
Low E2/Argon Gray OBS Full Qty_ (On Sashes Only) Alum
Tempered Qty_ Keepsafe Qty_
NOTE: Tempered glass will be installed to meet building codes.
ri
Col Sculp Col Flat Diamond
Top
WhiteYes
No FullTan
Wd Grain Bottom
Brass
Warranty: Manufacturer's Warranty sent upon completion.
cv- 4. Existing units NOT to be replaced: t7L1'T4 9-"r G - y "q--- X
t
5. If applicable, after completion of project, the application and removal (storage) of shutter panels shall be the responsibility of the purchas `n tbje
event the project requires the installation of storm shutters or egress windows, Contractor will not re -install any effected security bars.
6. Special instructions:
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.
NOTE: THE WARRANTY PROVISIONS AS STATED ON THE REVERSE HAVE BEEN EXPLAINED AND t/WE UNDERSTAND THEM FULL
ADDITIONAL PROVISIONS AND WARRANTIES ARE STATED ON THE REVERSE SIDE AND ARE A PART OF THIS CONTRACT. X
Please read the following bold type and initial corresponding line. Verbal understandings and agreements with representative shall not be binding. All understandings and agr4e.. is must be set forth inwritinginthisContract. Due to climatic conditions, interior condensation may occur. Purchaser In=
S-Tax
The TOTAL PRICE for all Labor & Materials (including any applicable discount) is $ C, (?Z 00 7-1o
U Z
Down Payment $ 00 x (_
Balance Payable $ Z pp $
C ZPrice $ Terms: Credit O (Subject to the approval of the Credit Department) -
yam G ICash (Final Payment payable to installer upon completion) Funded by: Bank:' L) F1)L
City St
Acct #
10% Preferred Customer Discount (PCD) awarded for any future Sears Home Improvement Products purchases. Current pricing available for one (1) year.
If this is a credit transaction, the agreement for credit is contained in a separate document which is incorporated herein by reference and made a parthereof. I/We the undersigned are hereby authorizing Sears Home Improvement Products, Inc. to verify and review my/our credit record with an independentcreditreportingagencyandreleasethemfromallliabilityincurredfrominadvertentomissionsorerrors.
IN WITNESS WHEREOF Purchaser(s) have hereunto signed their name(s) this Z da of 20C' Precei t of a true co y F>pIZ,Lw , _and acknowledgecopyofthisContractandunlessotherwisespecified, 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 timepriortomidnightofthethirddayafterthedateofthistransaction.. See accompanying notice of cancellation form for anexplanationofthisright.
Signature affixed below acts as receipt that Purchaser(s) recelved separate cancellation forms.
SUBMITTED R rasentative Date Purchaser
Dato
z-tLaACCEPTEDBV: Sears Home Improvement Products, Inc. Dato Purchaser ---
nate
E2-SO 07/04