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GLy
GLENFI.E
Development Group
OWNER/BUILDER ADDENDUM TO BUILDING PERMIT NUMBER(S) 7'U sOWNER/BUILDER
3
ADDRESS L-! 7 W AI (' rj Sou r i 6s 4— 3
-The undersigned applicant asserts that she or he is exempt from the original contractor licensing requirement
of Arizona Revised Statues Chapter 10, Title 32 on the basis of:
ARS 32-1121.A.5. The applicant owns the property and shall occupy the property, and does not intend
the property to be for sale or rent, and shall have the work performed by the applicant alone, or by the
applicant with employees of the applicant, and/or performed by duly licensed contractor(s)all of whom
are identified below or on the attached.
— ARS 32-1121.A.6. The applicant owns the property and shall have the work performed only by duly
licensed contractor(s) all of whom are identified below or on the attached.
Contractor/Company Name License Number Classification
= ARS 32-1121.A.7. The applicant is a registered architect or engineer, or employee of registered
architect or engineer engaged in professional practice, not as a contractor.
The undersigned swears and affirms that the information herein is true and accurate, and acknowledges that
the filing of an application containing false or incorrect information with the intent to avoid the licensing or
tax requirements of the State of Arizona is "unworn falsification," a criminal misdemeanor.
£v15 770 raj °CUIZ TIO -,204.1.3
Printed Name of Owner Signature of Owner Date
City of Glendale * 5850 West Glendale Avenue_*Glendale, Arizona 85301-2599 * (602) 930-2800
SANTA GRANDE MHP 5 3
MFR. YR ,1978 4375 W. Missouri Ave }�
Glendale,AZ 85301 b . t
*This Purchase Agreement supersedes all others written or verbal'
PURCHASER(S): 'PHONE DATE
Luis Flores September 5 2013
ADDRESS SALESPERSON
4375 W.Missouri Ave Glendale Arizona 85301 Tomi Pecina
DELIVERY ADDRESS
4375 W.Missouri Ave Glendale Arizona 85301 i
MAKE S MODEL • MDL YEAR BD.ROOMS FLOOR SIZE HITCH SIZE STOCK NUMBER
Baindridge 1978 2 L 64 w 14 L 84 w 14 SG3
SERIAL NUMBER COLOR PROPOSED DELIVERY DATE KEY NUMBERS
S814828 NEW ®USED September 5 2013
PRICE OF HOME AND TAXABLE ITEMS $ 2,100.00
OTHER TAXABLE ITEMS 0.00
NON-TAXABLE ITEMS 0.00
SUB-TOTAL $ 2,100.00
BUYER(S)WERE GIVE A COPY OF THE COMMUNITY RULES
®ULATIONS SALES TAX 000
j PROCESSING FEE 0.00
,�!: Th G�f TITLE FEE 0.00
VARIOUS FEES AND INSURANCE 0.00
(initials) (Initials) 1.TOTAL PURCHASE PRICE
$ 2,100.00
DEPOSIT $ 2,100.00
Home Sold in "AS IS,WHERE IS"Condition with no BALANCE DOWN PAYMENT $ 0.00
warranties promised or implied. 2.LESS TOTAL PAYMENTS MADE $ 2,100.00
`I.0 :�t 3.BALANCE OWED ON 9/1/13 $ 0.00
(Initials) (Initials)
REMARKS:
Home sold in"As Is/Where Is"condition. No warranties.
r Santa Grande MHO "SELLER" SIGNED X "PURCHASER"
Not sal nie s Signed and A by arlOfficer of the Company or an Authorized Agent Luis, Flores
i �� �
"
By , VV/rj//j
SIGNED X "PURCHASER„
mi Pecina, Manager