HomeMy WebLinkAbout139 Brushcreek Drive 17-1574; HVACMay 31 17, 07:32a p.1
EC
MAY 3 4
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No• A!I— I57]
Documented Construction Value: $ y . M
Job Address: Z3 lHistoric District: Yes No Parcel
ID: ^l "3 - S/ 15 06 ")OMResidential Commercial Type of
Work: New Addition Alteration [!'Repair A Demo Change of Use[] move Description of
Work: Plan Review
Contact Person: Title: Phone: Fax:
Email:_ Af Property Owner
Information CAPL. Name f.:
rN tl/fCI rGA!( Phone: AD% ' yy 7 Street: /, q
d4e&YA), X , Resident of property?: City, State
Zip: jel!,C ,4,4 / l oZ%?L Contractor Information
q Name /"/
r /
i7%
j/
f rr f /i%` • Phone: 07 r'' 10 Street: yyK
Xd1_,1^/ 4Vr Fax: Ve) f_-, ' City, State
Zip: O w'—c- `) zZ State License No.: Name: Street:
City,
St,
Zip: Bonding Company:
Address: Architect/
Engineer
Information Phone: Fax:
E-
mail:
Mortgage Lender:
Address: WARNING
TO
OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE
FOR IMPROVEMENTS TO YOUR PROPERTY. A, NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Application
is
hereby made to obtain a permit to do the work and installations as indicated. I 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. FBC 105.
3 Shall be inscribed with the date of application and the code in effect as of that date: 5"' Edition (2014) Florida Building Code Revised: June
30.2015 Permit Application I W3 (
f
May 31 17, 07:32a
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 requirements of Florida Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy of the executed contract is required
in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal.
The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in
accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value,
credit will be applied to your permit fees when the permit is issued.
OWNER'S AFFIDAVIT: I 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.
st ature of n /.1lgcnt Dalc 1
Print
Gksucr/Agent's Nance 17
Signature
of Contractor/Agent Date Print
Cont. actor/Agent's Acme mguatun
arrversry-Mare t Signatureoflc&ary•S ofFldttigs., Notary
Public - State o' flofids µ
PVa EILEEN DINNAN Notary
Public -State of Florida r , —
11
Commission N FF 9E.0376 my
Empires Mal a,2D21 WF, Commission it FF 960376My Comm.
Comm,
Expires Mar S. 202Dn:,n teathroughNatrona)Nc pryAss 8o
ded Owner/
Agent is through
National NotAssn. Contractor/
Agent is Personally Known to Me or Produced
ID ^ Type of fD fL G . Produced ID Type of ID BELOW
IS FOR OFFICE USE ONLY Permits
Required: Building Electrical Mechanical Plumbing Gas[] Roof Constructions
Type: Total
Sq Ft of Bldg: Occupancy
Use: Min.
Occupancy Load: New
Construction: Electric - # of Amps Fire
Sprinkler Permit: Yes No Flood
Zone: of
Stories: Plumbing - #
of Fixtures of
Heads Fire Alarm Permit: Yes Nc APPROVALS:
ZONING: UTILITIES: WASTE WATER: ENGINEERING:
FIRE: BUILDING: COMMENTS:
Revised:
June 30, 2015 Permit Application
May 31 ,17, 07:32a
r
p.3
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: s oZG dz)17
I hereby name and appoint: /J, "I)Al
an agent of:
of
to be my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all things
necessary to this appointment for (check only one option):
The specific permit and application for work located at:
Strcet Address)
Expiration Date for This Limited Power of Attorney: IM, Z /17
License Holder Name:
r
State License Dumber. Ck-- i2A" Signature
of License Holdeur' STATE
OF FLORIDA COUNTY
OF The
foregoing instrument was acknowledged before me this 06 day of , 200
0j by &J&&O p eT, r who i XpersonalIy known to
me or who has produced identification
and who did (did not) take an oath. ignaturc
Notary
Seal) Print
or type name Notaiy
Public -State Of EILEEN
DINNAN ommission
NotaryPublic - 5ta1e of FloridaflorlGa Commission ,
r FF 960378 No. '
My
Commission Expires: lj My
Comm; Expires Mar 5.2020 OU
n 9anCe0ihrough National Rotary Assn. Rev.
08.12) as
May 3017, 03:31 p
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Matthew Roberts, Inc.
P.O. Box 1659
Oviedo FL 32762-1659
Phone: 407-365-1222
WWW.MATTHEWROBERTSINC.COM
COD
5/25/2017 0000033119 0007987
1.00 Estimate to install new 3.0 ton heat pump split system with 10
KW's auxiliary heat and R-410a refrigerant. Installation to
include new copper refrigerant lines, float switch & tee to help
avoid water leaks, new 3/4" plywood top for the air handler
stand, Remove flex and Reline stand, pad for the outdoor unit
and a wifi digital programmable thermostat.
OPTION #2 3- stage
Rheem 17.5 SEER / 35,200 BTU's
Condenser
M# RP1736AJVCA / S# W121717142
Air Handier
M# RH2T3617SEACJA / S# 121717277
Heater
M# RXBH-1724B10J
25 amp SD QO
Original Owner's Warranty information:
1 year on labor
5 years on thermostat
10 years conditional manufacturer's warranty on functional
parts & compressor
TOTAL.
I how the authority to order the above work and do so order as oudired above.
R Is agreec that the seller wig reain Ilk lo any equpment or material furolshad
the seler shag have the right to remove same and Lie seller wil be held
until bnal &complete paymeril is made, and d settlemetl is not made as agreed,
harmless for any damages resurIng from the removal thereat
N Parts as recorded are warranted as per manufacturer specificatio'm
The Labor charge as recorded here relative a the egLipmenlserviced as noted,
is guaranteed for a period of 30 days. We do nct of course, guaranty ott er parts
than those we inatah. Ifrepairs later become necessa-y due b the c her defective
parts, they will be charnei secaraleN..
Jennifer Clark
139 Brushcreek Drive
Sanford FL 32771
Jennifer Clark
139 Brushcreek Drive
Sanford FL 32771
WE APPRECIATE YOUR BUSINESS