HomeMy WebLinkAboutBLD2018-00428 Furnance and Heat Pump - BLD Permit / Conditions - 10/30/2018 IDOL a) � O
o m 0) .. CD 3 �� m m r�
3 v o CD C -0I m
CD
ZJ
_ d
CD �, c o z m G�
N T 0 O O w N D cn cn
°° C c : m m n m C� =l 0
(D m m Z
cc cn = mm Z � � ZC) X0
�! v' rD 3 n o � z � � � n �
= �
z CL co Ommcnn0m = -
' v
N T O O ::3� � C) 0 N) . Dn 0
� Nzm2 � � c Z
� CD 00 � mnz co :3o
= O G) co CO O
N o r Z C cn
z C3 C/) i A C
m �, oxm Z
cn mn � -�
z > -�
-n a: cn cn W 9 o p X O p
_
� s: Q: m m �
T 7-3 a CD CD CD 0 0- p � m z� � Cn r m
N v N v tz CO00 0 W r r
m
0 � � ov � a Zn
co Acn
= moo o OT
m o_0 (D �• o o Cn M o N 0
71, (D
' ° D 0s 0) r � Z
CD m � m � 3 Q°
o M 17 p 00
:3 y v r C
s m 0 o o o r v C Z
m —1
c v c y o -1 w 0 c p
CD CD � � Oz -� m p
Z
o °' -zj r Z z rn
Q O -n mC
o _ p O mCD CD
m
r
0 3 3 Q 0O m coo
N co m 0 w
a v E -o ,, D CO m
DCD M Z
m r � D m
-n CD CD � o x
D CD p 3 a cn z '�
� cn ? (0 CD
o ?
z z z ou o cn V f
z z z 3 CD CD C C�
Cn - N Al
w w w m w y' D o 90 -
000 m .yc O O Ep
0 0 0 o m p'i Za
�—' ao 00 w _ (D m : p U)
� � 4A n 3 m o
W 0) 0000 w O O n
h m m
0 0 0 0 X Cn n ca
CD w 2 cn m r o r
(D m m m N �.
(A N cn O n ' � U Q N �'
6w
ID o 00
W CO O
w Co Co Co n w C3 O 0 Cp N
ID.
CD
0 0 0 C IV N O
0 0 0 N O O �I
CD - N wN
O O o — co co co N N
lb
W � U) -u (� vo (np m 0
rn73 � a � o (fl �
o v ° (D N Z
3 v c rn
0o N �` & � 0 -9 CD X b oo >< � v D x � 6 D ><
CD Do' cm � � (D `< O °� = m � - to CO
iv o D
-u g 3 0 o C �. (D CD
CD (D (D c N n r Z
co r_ � o �I � ° p (n
O c < ca W n ' � m (D (D v o O -I
Z(nm m � 0 CD o ° �, 3 Fl o 00
OT � o30 � v � � � � (n � � 0,
� oo (n (n -
(p Q N (D .» (D Q o v Z OOL ° CD .0
_ 0 0 — CD
� � �' cOnmu> (� Er vXv m ° Q- O
p O (n (D Q (D � n l< (n O (D (D
(n w (n p CD (n v c. (n - m
°' (D cA 0 � (n fD � ° °' � o < D w 3 �
CO)-a - (D c cr 3 Q Q " ° Xw cn
c ° 33. 0 0 Q o (Q CD a o °' ° v Q
rQ � � o• � n v 070, CD asv -0 CD 00
r O ? (D > p :3 CD O3 m (D Q(D m
Z N � O Q cQ v ((nn �. Q n TI
D O ° j _° o'� N N ai (fl -0 (D (o (n' r
O•< - vvan ( v (D vOo QNc n
O? -(Dcn � � �N(/� � 00n CD o (D O �
� --oQp o
(n CD CC o0- � CD O m -av PLC o :3Q(D ). N c (D m
: O p cOv < Nrn � CD (D O (D COoo N (nl<Dn O O (D ( Q (n nm((n
o > OCQ v m 3 `� �� 0 Q m CD
CD n0 (n � � N g v -'`< c � = � = y
oo � 0vo =r 3Q 000 cn
o C� O � n � < = � :3 � �
o D_ Z ((Dn C" m•SD 3 (D � 0 - _0 m
CD o
wv, v 3 m Q c < O
Ozc 6 — - c x m � °
m ? D S?o � vOi °CD :3 n < CD
v
(Q < Q q lD o << N
o O 0M in
y = (n o v (D 3 - m (D On m
o ZN O v " - N O (D 0 :TJ
iD �. rno � � — w w m oo
�. o0 CD ° ° 0 c
n. X Oo � (fin � � n (Qw o m ° o - cn
1J � W '< (Dm0 o v (n o W Oz
v 3 � �' =
° ` Hoch - o " o CD CD C:o � wQ 00
cn m N o v m (n v ° a C
'a -0 CD a fD ° -� CD c (D
CD oX mQN (� �� m (Qa o3Q °o -
3 � rn v m � ° v W
to DO o O BCD v � �
Dm ZN Z3 ( v 3 �(Q m c
C Z cn n v _ �-* (D (p (D r
(D -1 O a �n � � � Q - CD
-0 vc
D - (D 0 CD (D ° zy v z
< ° o'
< z 0 < ° _ o 0 c o v 3 c D O
o rn N . n � ?D 9 < (n (n (D N - 0
�? n ° N o - 0 a n� c � D
o � �° o QZ — ' ; O oO C �CDCD o < zZ w ° < v �
Z0 0 -, -, C Q av � E � E D
nQ < (a a o 3 CD. W Z
� Q _SC 3 m 0l< � X ° � 0
-I CD
(n . = v m x o
(D O -� �a. Z3 ° ° � n o � o D
w Toac(D� Q- (n ° o Q ° Z3 z D 0
o � Q� ° cc D W0
W Cl)N 0 � O (nc N (D � w —I
(D CD (p CAD N 0- m
o (D
W � (r •A W N
O
W
a X o Q .- -i X-0 (nD �� m D c v xcnU) > XO ><
N i j d .' O 3 0 0 z TI Q(D
07
°° 0 cD 1p 0 0 N 0 � = M m C a) n
0 z
M
-, am o cn mx � (D o
Wp zz
cn c N 0 v � � mD, bo
a m o r' <m CD n ?Om ^'
v 3 v cfl 3 0 r �' cD m -G z
5' o n o c M r cn -i"n r(D =r — v
m < `< a ? � `n v �' m0 �i cn m �. 0
QN o n0 � � Q 3 xmD � m (n
r: O 0 cn 0 CCD cn O - �^ D v, N �
v v
v go o cD v — m Zm0 0 3 m
-0 O O Q n x cr CD Q n Z ° c0
_0w cD �. 0 m CD cn
° o m 2 . cn a � � o
o< v m (n �' Q 3 -0 m 0 < D = � cQ v m
v cn � s v O Cz zr �
o ° 3 _ °' O - ° 3 cn r- (D ��. (D
0 0- N C gyp' n (DD N a m r (n n
3 CD o Q0 c ° CD `� n0 � cn o � c
m 3 0 °' cQ Dim cQ ° =' fl
O p Z -i m a CL N
CD
v mCD om CDQ gO - a
(D n � m = o°i cso cn Zz2 v :3 ° n
m Fn
Nm 3 -0 � 0 m r � m m n CD
Q O cQ O N O -O N Zll �_ (D
co < (n > o z � (n ZF0 CO
g o 0 c O O cD 3 cQ D = Z (n cD 3 iv
ao0 � °� Q � o w (n -imp v m
cu r ° ° Q 3a m v OZm CD n n
o v 3 �' -0 (D ° CD �' = D n 0 0 (D a) o SO D
o (D —v ° (D �. (D v Cr r = 3 (D r Z �— N
a - D m
a � 0 3m ° v � Dm c CD6 Dv v
a) o cD w 7 (D 3 CD N cn n (� 0 2` C C -'� O Z
w mom 0 Qom'. � cn 3 w = Dm v � � Q co 00
w z 3 ° (� 0 � co zy (3D Q D r n (D � co s o Z o m
Z (n 0 (D — << fD
b cn o o �' cn (n m ph N m
pO =, 0 3 � m m D � Q � cm 00O 00O
3 0 -h �, v 0• O c� --i �, 0 m
O a 0 cD ° Q 0 -n a r.�
o y (n 3 c� - cD M � 0 � ("D 0
c°i 0 0 (D ° c ( Dz 0 -0a o ° CD ?CD n a (D 3 r-1 0- ° O
3 W 0 -0 (n N c0 0 x m cfl r
oom N o v Qa- 0 mn m m ° Cr
a 0
<n � CD
0 ° ai � C
OD 0 = Q� 0' N c O :(J m v
� n ° 0Q Q �lZ 0 m 3n
o m D n� ° o (n m � 0 0 cD
7 � -0 m 0
� ° Q cQ CD ° m v 0 � � ? 5.
o n
v �;
CD 0 cn 0 3 °' 0 0 (� � 0 3
o =1 °o O cm:3 �0 v m0 ovcon
`< (n m
N O IIl O 0 (D O (D 0 (n O O
(D :3x o- = -n
D n 0 �
=o D
_ cO m (n 0 D W
c CD r o 5- Cw3 a
c
O
((n N Z3 0 3 n m < 0 cQ Q C)
m mD o 0
v
p 3 y' n c0 5. o -� � 0 3
CD 0 co �' * o v cQ a � 2 �c Dm �
N = Z (nO N
0 O c
v w c — c) m v
° ° (CD CD Q �' (D O lD n
CD (D
CA) ca (D 0 z A
0
0 (D (n Q (D Z � LU
(D c N S co
°° 0.
0 CONCRETE MECHANICAL MANUFACTURED HOME G)
C) Date By z
T Footings I Setbacks Gas Piping Ribbons i
C) Intenor Date By Interior.Date By Date By M
CD X
Exterior Date By Exterior-Date Set-up C_
INSULAR oo ' ON ------ 0
Point Load I Isolated Footings BG I SLAB I n NSULATION Date By X
Date By Date By FIRE DEPARTMENT z
_foundation Walls Floors Date By
Date By Data By DECKS
FRAMING Walls Date By
Date By
Date By PROPANE TANKS
PLUMBING Vault Data By
Data By OTHER
Groundwork Attic
Date B Dat Typo,
e By
Date By
MWIV DRYWALL TYPA-
Int Brace Wall Date By 00
-0 Date By bats By
m FINAL INSPECTION 0
M
(D(n Water Line Fire Sope ration
Date Date By Date By
y I Co
o Pass or Request Inspect. 6
CD
a Type of Insp. Fail Data Date Done By Comments
(D
00
(D
cn
0
0
0
3
----------
(0
(D
0
MASON COUNTY PERMIT NO ._ � __1
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W. Cedar•P.O. Box 186, Shelton, WA 98584
Shelton (360)427-9670•Belfair(360)275-4467•Elma(360) 482-5269
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION N.E.CONSTRUCTION LLC
Owner JOHN GUNTER Company Name
Mailing Address 50 NE HILLSIDE ACRES LN Mailing Address 5016 FAIRWOOD BLVD NE APT 9
City BELFAIR State wA Zip Code 98528 City TACOMA State WA Zip Code 98422
Phone 360-620-0083 Other Ph. Phone 206-483-8157 Other Ph.
Lien/Title Holder Contractor Reg. # NECONCL833JP Exp. 4/17/2019
E mail address E Mail Address
Drivers Lic. # DOB Drivers Lic.# DOB
SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION- 12 Digit Parcel No 12321-31-90012 Fire District
Legal Description
Site Address(Please include street name, street number and city) 50 NE HILLSIDE ACRES LN,Belfair 98528
Directions to site WA-3 North. Left onto NE Old Belfair Hwy. Right on NE Newkirk Rd. Silight left onto Hillside Acres Ln
Is property within 200' of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs > 15%
TYPE OF JOB - New Add Alt Repair Other Use of Building
Location of Fixtures/Units- 1 st Floor 2nd Floor Basement Garage Closet E-1
PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS
Type of Fixture No. of Fixtures Fees Fuel Type:Electric—LPG_Natural Gas_Heat Pump_
Toilets Type of Unit No. of Units Fees
Bathroom Sink Furnace 1
Bath Tubs Heatpumps 1
Showers Spot Vent Fan
Water Heater Propane Tank
Clothes Washer Gas Outlets
Kithen Sinks Wood/Gas/Pellet Stove
Dishwasher Kitchen Exhaust Hood
Hosebibs Dryer Vent
Other Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL 2
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of
such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the necessary parties.If permission is
required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained
permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information
provided is accurate and grants employees of MasonAP
to the above described pr pery an tructure for review and inspection.
PROOF UATIO R`VY Y SGRESS INSPECTION.
14,X Date:
wWnOw_pWs Re sentativ Contractor i
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by: Planning Pd Ck# Date Bid Pd Receipt No.
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Occ Group—Type Constr.
Planning Department
Environmental Health Department
FEES
Plumbing & Base Fee Site Inspect on
Mechanical& Base fee UFC Plan Review Fee
Wood/Gas/Pellet Stove Fee Other
Violation Fee TOTAL FEES
Job:23733905 Page 1 of 6
111111111111111. Off ce Location: LA f-t i_v
Proposal Date 04i 06/2018 JJobNumber >,37319W) Sears Home Improvement Products,Inc.
Customer Name P.O BOX 522290
JO{N c_:�Rwrt R eaarfs 1024 FLORIDA CENTRAL PARKWAY
3!9
Customer's Home Phone Customer's Work Phone LONGWOOD,FL 32750-7579
Home Improvement Products PHONE(800)469-4663
Street Address Contractor License/Registration Number
50 NE HILLSIDE ACRES LN ESTIMATE AND PROPOSAL SEARSH1011LA
City State Zip Code
IS LLF!arR WA " ''' Is installation within city limits?
Installation Address County (Yes/No): '�:`s
Billing Address(if different from above) City State Zip Code Project Consultant Name&License No.(if applicable)
)OSH1JA !11E`rFR :i`t)27
Description of the Pro ect and Description of the Significant Materials to be Used and Equipment to be installed
Interior Products / Exterior Products Home Warranty
❑Vinyl Siding QRoofing ✓JIVAC ❑Kitchen Remodeling QCountertop EJ Whole House
Coating MWindows Attic Insulation ❑Cabinet Refacing ❑Flooring ElSystem
Painting ❑Doors ❑Garage Doors nBathroom ❑Appliance
SPECIAL INSTRUCTIONS:
NO HEAT/NO AIR, PRIORITY INSTALL REQUIRED
MOLD REMEDIATION: This Estimate and Proposal assumes that no mold remediation will be needed during installation work. If, upon inspection
by the contractor or others, it is learned that mold remediation is necessary then Customer must arrange and pay for such remediation by a qualified
person prior to the start or continuation of work. If Customer fails to arrange for necessary mold remediation within thirty(30)days, Sears may cancel this
contract upon written notice to Customer,
ASBESTOS ABATEMENT: This Estimate and Proposal assumes that there are no asbestos containing materials("ACMs")that would be disturbed in
the performance of the installation work. If upon further inspection by the contractor or others it is learned that ACMs have to be disturbed to perform work,
then Customer must arrange and pay for abatement of asbestos by a qualified person prior to the start or continuation of work. If Customer fails to arrange
for necessary asbestos abatement within thirty(30)days,Sears may cancel this contract upon written notice to Customer.
The TOTAL PRICE including all labor,material,taxes and any applicable discount is $ �,o, 313.66, Contract Price $9,524.11
Earnest Money $ -Ioo.oo State Sales Tax $ 809.55
*INITIAL PAYMENT(Not to exceed 30%of TOTAL PRICE;payment is due prior to Local Sales Tax $ MO
o0
ordering of product;excludes HVAC in which the INITIAL PAYMENT is 100%.) $9,8:3 3 6(-,
Initial Payment Subtotal $ 10 66
FINAL PAYMENT(balance payable upon completion of job) $7 7W Total Amount Due $ t-n,333.6f>
*The Initial Payment is due prior to Sears ordering products.A Cancellation Fee of up to$ 71f 1 0 o plus any incurred materials costs,up to 30%
of the Total Price,may be assessed.
Financing: The form and method by which the Customer(s) will pay is described in a separate Cash/Credit Card Payment Addendum made a part of and
incorporated into this contract by reference.
All of the above check boxes(and associated Product Addendum(s)),"Work NOT to be done:","Additional work to be done:","Special Instructions:",
"Mold Remediation","Asbestos Abatement,"and"Financing:"sections have been reviewed by and explained to me. Product Addendum(s)is/are
made a part of and incorporated into this contract by reference. G
Customer(s)initials
NOTICE TO BUYER: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD(3) BUSINESS DAY,
FIVE (5) BUSINESS DAYS IN MARYLAND, (FIVE (5) BUSINESS DAYS IN ALASKA, SEVEN (7) BUSINESS DAYS IN MARYLAND, FIFTEEN(15)
BUSINESS DAYS IN NORTH DAKOTA IF YOU ARE 65 OR OLDER) AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF
CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT.
SK1-(Dig.) Rev 10/16/17
Job:23733905 Page 2 of 6
Heating and Cooling Addendum
Consultation Info
-7,7 S ER
14UTA MFY11
Lead Number: Date: 0 4 0 0 8 ales Rep: 110.01
' G
Customer Name: Phone: 0 r.,-1 0 0
Address
City: State: a
Descrlo'on of tht" and Ditddptio ofitii�l"cantMaten'als to be Used and Equipment to be installed
SYSTEM INFORMATION: AH RI#: o )M,
INSTALLATION TYPE:
(Split System/Package/Dual Fuel/Straight Cool/Heat Pump/Furnace):
EQUIPMENT BRAND:
FURNACE FUEL: (Gas/Oil/LP Gas/Electric): HEATING BTU:
SEER(up to): Cooling BTU: KW: AFUE (up to):
BOILER INFORMATION: EQUIPMENT BRAND:
New/Replacement/Conversion:
TYPE INSTALLATION: REMOVE AND DISCARD OLD BOILER
CONNECT TO EXISTING SUPPLY&RETURN PIPING
Boiler type (Water/Steam): BTU: AFUE (up to):
FUEL: (Gas, LIP Gas. Oil*): = Replace oil Filter*
*Oil Tank removal and replacement is the responsibility of the owner
The work to be done under this contract includes the following (where checked):
Specifications ( = Included Not Included)
NEW EQUIPMENT COMPONENT: ELECTRICAL: MISCELLANEOUS:
FURNACE/FAN COIL CONNECT TO EXISTING 0 LINE SET
CONDENSER UNIT INSTALL NEW DRAIN LINE
EVAPORATOR COIL FURNACE/FAN COIL 0 AUXILIARY DRAIN PAN
PACKAGE UNIT 0 CONDENSER UNIT 0 PAD
EVAP COOLER INSTALL NEW MAIN PANEL CONDENSATE PUMP
THERMOSTAT
INDOOR AIR QUALITY: FLUE VENTING AND/OR CHIMNEY:
HUMIDIFIER 0 INSTALL NEW VENTING OR CHIMNEY
AIR CLEANER RE-USE EXISTING VENTING OR CHIMNEY
UV LIGHT
DUCTWORK: INSULATION:
INSTALL NEW DUCT SYSTEM 0 (BATT/BLOWN):
RE-USE EXISTING DUCT SYSTEM R-Value:
DUCT CLEANING
PLEASE NOTE that Sears is not responsible for correcting any existing code violations or pre-existing conditions of any
ductwork, piping, electrical supplies or equipment not being replaced at this time. If additional work is required, it will be
the customers responsibility. Any additional charges will be quoted and approved prior to the start of any additional
work
t ,
Job:23733905 Page 3 of 6
APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE:
The work will start approximately (Approximate Start Date)
It will be substantially completed by approximately F (Approximate Completion Date)
These dates are subject to change at the time the contract is accepted by Sears Home Improvement Products, Inc.("Sears")or at any other
time by mutual written agreement.Customer understands that the Approximate Start Date is only an estimated date and the Customer will be
contacted prior to this date to schedule the actual start date.
The TOTAL PRICE including all labor,material, Contract Price $
taxes and any discount is $
Initial Payment(not to exceed 30%of Total State Sales Tax ( %)$
Price unless Special Order) $ Local Sales Tax ( %)$
Final Payment(balance payable upon
completion of job) $
The Initial Payment is due prior to Sears ordering products. Total Amount Due $
Additional work to be done:
Work NOT to be done: Removal or moving or any walls; flooring, painting, wallpaper work; repairs of water or termite
damage to sub-floors or walls; electrical or plumbing work outside of this kitchen or bath project.
THE CONTRACT PRICE Price A copy of the terms and conditions of the
INCLUDES: Master Protection Agreement or the Repair
-Year Master Protection A reement ,/ Protection Agreement(as applicable)have
g 0 been provided to Customer.
-Year Repair Protection Agreement $
Initials:
SEARS'LIMITED WARRANTY ON INSTALLATION
In addition to any manufacturer warranty extended to you on the product(s)used(which warranty becomes effective the date the merchandise is
installed),if the workmanship(or application)of any Sears'arranged installation proves faulty within one year after the completion of installation,the
upon notice from you Sears will cause such faults to be corrected by repair at no additional cost to you. If Sears determines that repair is not
commercially practicable or cannot be timely made,then,at Sears'sole discretion,Sears may elect to provide replacement or refund.Service
under this Limited Warranty is available by calling Sears Home Improvement Products at 1.800-222-5030,Option 4.This warranty gives you
specific legal rights,and you may also have other rights that vary from State to State.
Job:23733905 Page 4 of 6
Proposal Items
Code Description Unit of Measure Units
OEM
00001 Misc,Acsry. HVAC Misc Material Items Each 1.00
01657 Misc,Lset. Model:3/8 X 7/8 X 50'LS,3/8 X 7/8 X 50'Line Set Each 1.00
10566 MPA;5 Years. Heat Pump,410A Each 1.00
10569 MPA;5 Years. Furnace Electric,Air Handler/Fan Coil 410A Each 1.00
18488 Kenmore,Heat Strip,Fan Coil, Model:EHK15AKB,ELECT HTR, 15KW w/bkr,S Each 1.00
21830 Honeywell,Tstat,Prog- Model:TH8321 WF1001,Wi-Fi VisionPRO 8000 Each 1.00
Programmable,3H/2C,Touchscreen Thermostat,7 Da
44045 Kenmore,Fan Coil,VS. Model:FVM4X4800BL,FANCOIL-VS TXV 4T R410A AL Each 1.00
45640 Kenmore,HP Cond,MLine. Model(C,H,T)SH548GK`, 15S,4t,Vert,sgl-stg Copeland Each 1.00
Comm
H105 INSTALL SS MISC. New pad for condenser Each 1.00
H151 INSTALL EL SPLIT. Complete system change out Condenser&Air Handler Each 1,00
(HeatPump)
H608 INSTALL MISC. TITLE 24:Duct testing incl.trip&setup,duct test&6R forms Each 1.00
H643 INSTALL MISC. New float switch Each 1.00
H900 ELECTRICAL. Circuit 115v 20 amp up to 20 feet w/GFI circuit protection Each 1.00
H923 ELECTRICAL. Low voltage wire-same location Each 1.00
H991 PM Check. 1 st Year PM Check Per Job 1.00
Job:23733905 Page 5 of 6
ADDITIONAL PROVISIONS
Proposal and Approval. Sears offers to furnish the materials and arrange for their delivery and installation as specified on the first page and/or the attached
sketches and specif cation sheets for the TOTAL PRICE shown. This offer must be approved by the Installation Department. If this is a credit sale or a
payment on completion sale, it must be approved by the Credit Sales Department. If this proposal is not approved or the installation cannot be made in
accordance with the law,this offer will be withdrawn and any payments you have made will be refunded to you.Any materials left over after the installation
has been completed are Sears property and will be removed by Sears.
Installation. I understand that Sears will not install the materials but will arrange for the installation. Sears is not responsible for materials
or installation NOT furnished or arranged by Sears. Sears' installation contractor(s)will obtain all building permits required by local law. For homes located
in historic or landmark zoning districts, Customer will be responsible for obtaining required approvals and related permits prior to the commencement
of work on this contract.
Authorization. I authorize Sears to: (1) arrange for a contractor (licensed where required by law) to make the installation of materials; (2) issue a work
order for this installation to a contractor; (3)inspect the installation; and (4)pay the contractor when the installation is complete if I have signed a certificate
that the installation has been completed to my satisfaction.
Delays in Installation. I agree that Sears is not responsible for delays in delivery or installation due to weather,fire, strikes,war, government regulations or
any causes beyond Sears'control.
Oral Agreements and Changes in Contract. I understand that there are no oral agreements between Sears and me. Everything I expect Sears to do has
been included in writing in this contract.Nothing can be changed in this contract unless it is in writing on a separate form accepted by me and Sears.
Responsibility of Buyer. I agree that any information or measurements that I give to Sears are correct and complete. I am responsible for any special
work described in this contract.
Electrical & Plumbing Service. I will provide adequate electrical and/or plumbing service(s) to run any newly installed appliances or other furnishings. If
the electrical and/or plumbing service(s) do not meet the standards of the utility company or electrical and/or plumbing codes, I will make the necessary
changes at my expense unless Sears has agreed in this contract to make the changes.
Payment.I will pay Sears the cash price that covers the price of material and installation as shown on the first page.
W2rranjy Information.Appropriate product warranty documents will be given to me by Sears. Sears'Warranty on Installation is displayed in the Product
Addendum.
(Dig.)Rev 06/07/17
Job:23733905 Page 6 of 6
NOTICE TO BUYER
1. DO NOT SIGN THEAGREEMENT IFANY OF THE SPACES INTENDED FORTHE AGREED TERMS TO THE EXTENT OF THE AVAILABLE INFORMATION
ARE LEFT BLANK.
2. YOU ARE ENTITLED TO A COPY OF THIS AGREEMENT AT THE TIME YOU SIGN IT.KEEP IT TO PROTECT YOUR LEGAL RIGHTS.
3. YOU MAY PAY OFF THE FULL UNPAID BALANCE DUE UNDER THE AGREEMENT AT ANY TIME,AND IN SO DOING YOU SHALL BE ENTITLED TO
A FULL REBATE OF THE UNEARNED FINANCE AND INSURANCE CHARGES.
4. YOU MAY CANCEL THIS TRANSACTION,WITHOUT ANY PENALTY OR OBLIGATION,WITHIN THREE(3)BUSINESS DAYS,FIVE(5)BUSINESS
DAYS IN MARYLAND,(FIVE(5)BUSINESS DAYS IN ALASKA,SEVEN(7)BUSINESS DAYS IN MARYLAND,FIFTEEN(15)BUSINESS DAYS IN NORTH
DAKOTA IF YOU ARE 65 OR OLDER)FROM THE ABOVE DATE.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION
OF THIS RIGHT.FAILURE TO EXERCISE THIS OPTION,HOWEVER,WILL NOT INTERFERE WITH ANY OTHER REMEDIES AGAINST THE RETAIL
SELLER YOU MAY POSSESS.IF YOU WISH,YOU MAY USE THIS PAGE AS NOTIFICATION BY WRITING 1 HEREBY RESCIND"AND ADDING YOUR
NAME AND ADDRESS.A DUPLICATE OF THIS RECEIPT IS PROVIDED BY THE SELLER FOR YOUR RECORDS.
5. CANCELLATION FEE. I UNDERSTAND THAT SEARS, UPON ENTERING INTO THIS AGREEMENT, WILL PROMPTLY INCUR SIGNIFICANT
COSTS TO START MY PROJECT. FOR THIS REASON, I AGREE THAT SEARS HOME IMPROVEMENT PRODUCTS WILL RETAIN AS A
CANCELLATION FEE THE "EARNEST MONEY" AMOUNT SHOWN AS PART OF THE TOTAL PRICE IN THE EVENT THAT I ELECT TO
CANCEL THE AGREEMENT AT ANY TIME AFTER THE EXPIRATION OF ANY LEGAL RIGHT OF RECISION. THIS CANCELLATION FEE WILL
BE IN ADDITION TO ANY AMOUNTS I MAY OWE, AND WHICH I AGREE SEARS MAY RECOVER DIRECTLY FROM MY INITIAL PAYMENT,
FOR MATERIALS ALREADY ORDERED BY SEARS PRIOR TO CANCELLATION.
6. IT SHALL NOT BE LEGAL FOR THE SELLER TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TO
REPOSSESS GOODS PURCHASED UNDER THIS AGREEMENT.
NOTICE TO WASHINGTON RESIDENTS
The contractor is registered with the State of Washington, registration no. SEARSH1011LA, as a general/specialty contractor and
has posted with the state a bond or cash deposit of$12,000 for the purpose of satisfying claims against the contractor for negligent
or improper work or breach of contract in the conduct of the contractor's business. The expiration date of this contractor's
registration is 08/02/2018. THIS BOND OR CASH DEPOSIT MAY NOT BE SUFFICIENT TO COVER A CLAIM WHICH MIGHT
ARISE FROM THE WORK DONE UNDER YOUR CONTRACT. This bond or deposit is not for your exclusive use because it
covers all work performed by this contractor. The bond or deposit is intended to pay valid claims up to $12,000 that you and other
customers, suppliers, subcontractors, or taxing authorities may have. FOR GREATER PROTECTION YOU MAY WITHHOLD A
PERCENTAGE OF YOUR CONTRACT. You may withhold a contractually defined percentage of your construction contract as
retainage for a stated period of time to provide protection to you and help insure that your project will be completed as required by
your contract. YOUR PROPERTY MAY BE LIENED. If a supplier of materials used in your construction project or an employee or
subcontractor of your contractor or subcontractors is not paid, your property may be liened to force payment and you could pay
twice for the same work. FOR ADDITIONAL PROTECTION, YOU MAY REQUEST THE CONTRACTOR TO PROVIDE YOU
WITH ORIGINAL "LIEN RELEASE" DOCUMENTS FROM EACH SUPPLIER OR SUBCONTRACTOR ON YOUR PROJECT. The
contractor is required to provide you further information about lien release documents if you request it. General information is also
available from the Department of Labor and Industries. I have received a copy of this disclosure statement.
Customer's signature Customer's signature
Ac� "'!i 04/0 6,"1 OJ'S
Customer's signature Date Customer's signature Date
Accepted by Sears Home Improvement Products, Inc.("Sears")on by:
Date Management Representative
SSPN_WA (Dig.) Rev 06/16/2017