HomeMy WebLinkAbout802 Northlake Dr 17-1615; HVAC CHANGE OUT NO DUCTr ,
4
jUN 1 20 CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No
Documented Construction Value: $ Q
Job Address: r Qistori{c District: Yes No
Parcel ID: - 3C— , /,3 _ $C Residentiaig Commercial
Type of Work: New Addition Alterations Repair Demo Change of Use Move
Description of Work:
Plan Review Contact Person: V) 06 be Tittle:
Phone: CH D t' .977 & /Q /Fax: QEmail: 1"-M 2 Vo ice• CLrn
Property Owner Information
Name ,, /C/7` S Phone: '
AleStreet: X J,5,_ 1 r Resident of property? : /le
City, State Zip:
Contractor Information
Name ^ l
J r4hone:
Street: "' % FaxQ—
City, State Zip: State License No.: '/Q%/$ //10
Architect/Engineer Information
Name: Phone:
Street:
City, St, Zip:
Bonding Company:
Fax:
E-mail:
Mortgage Lender:
Address: 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 Pcmiit Application
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.
igna re of Owner/Agent Date Signature of Contractor/Agent DyK
J71 5
Print Own Agent's Na
p D6-of-xu1`7
ignature of N ary-State of Florida Date
FRANK RAMOS
Commission N GG 6026
My Commission Expires
Jun® 22, 2020 IOmFRF9WWqFR or
Produced ID Type ofIDF4 pc. zNyz-`1$j-56-3*-j
P ' ontractor/Agen ' ame
Signat ary-S to Mori Dane
r
TAMMY C SAWYER
3 Notary Pubtk - State of Florida
Commission 0 FF 991090
Contract ifs My Cor{n Expires Apr 21, 2020
j l gt Ttart Me or
Produced
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type: Occupancy Use:
Total Sq Ft of Bldg: Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
of Heads Fire Alarm Permit: Yes No
UTILITIES: WASTE WATER:
FIRE: BUILDING:
Revised: June 30, 2015 Permit Application
Roberts Mechanical Incorporated
10151 University Blvd. #116
Orlando, FL 32817
CAC1815016
FEIN 20-4414682
Mr. Joseph A Nicholas
Joseph A
P.O. Box 521386
Longwood, FL 32752-1386
Date 5/27/2017
Invoice # 4798-1
807 Northlake Drive
Sanford, FL 32773-6100
P.O. # Ship Date 5/27/2017
Terms Due Date 6/26/2017
Item Description Qty Price Amount
Labor OT found the unit low on refrigerant. added refrigerant and 1 120.00 120.00
leak checked. found a leak in the evaporator coil. model
twv024b14fa1 serial# L27358150. service address is
807 northlake Dr Sanford FL. David to bill.
R-22 Refrigerant 22 1 70.0070.00 sp
I
Total $
190.00 Roberts
Mechanical Incorporated david@rmihvacr.
com 407-405-2658 Payments/
Credits $0.00 407-
790-4776 Balance Due $190.00