HomeMy WebLinkAbout511 WiLton Cir; 17-2158; CHANGOUT HEAT PUMPJob Address: S 11
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: b
Documented Construction Value: $ 43 q 1b.
Historic District: Yes No
Parcel ID: Residential Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work:
Plan Review Contact Person: Title:
Phone: Fax: Email:
Property Owner Information
Name \k Phone: d% - ci 21 _-75 7
Street: A vV Resident of property?
City, State Zip: e3 2
Contractor Information
Name 'es , C Phone:
c:; 2-2-9 2 3
Street: 44 Q Fax:
City, State Zip: 3 ? ( State License No.: C"Ja g
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company: 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:.5t6 Edition (2014) Florida Building Code
Revised: June 30, 2015 Pennit 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 wader
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.
Signature of 04wmier/Agent Date gnature of C tractor/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Print Contractor/Agent's Name
Signature of Notary -State of Florid _
Y' DEBBIE BLANTON
MY COMMISSION Fr 17E648
eJ EXPIRES: February 25, 2019
oF oc •' Bonded Thru Notary Public Underwriters
Contractor/Agent is Personall Known to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
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
5.. v... .......... .. .............................
Gas Furnace Model # ..............................
A" Coil Model #'
Thermostat - Non-Prog/Program . Heat/Cool Heat Pu
A/H to be installed as follows: Garage Closet 4 Attic
Condensor to be installed as follows: t`'':
9 Thermidistat Other
Other
ACCESSORIES: ikc. N.I. INC. N.I. N.I.
New Platform For Air landler '' Existing Ref. Lines/Drain - Electronic Air Cleane , !
New Precast Slab for Condensor '•1 Condensate Pump Safety Switch
New Ref. Lines/Drain Dispose of Old EquipmentHigh Eff. Air Filter t SUPPLY
DUCT SYSTEM: INC N.I. RETURN AIR SYSTEM: INC. N.I. Connect
New Unit to Existing Duct Leave Existing As Is `•' New
1" Ductboard/Flexduct System V New Low Sidewall \, New
Ceiling Mounted ` SUPPLY
OUTLETS TO BE INSTALLED IN THE FOLLOWING LOCATIONS: Living Room Dining Room Kitchen Family
Room Bedroom Bath Room Closet Other: ELECTRICAL:
INC. N.I. INC. N.I. INC. N.I. Reconnect
Wiring to A/H & Heat . New Wiring to A/H & Heat Service. Increase To Amps Reconnect
Wiring to Condensor New Wiring to Condensor Comments:.
TOTAL
SELLING .................................. r SERVICE
CONTRACT ............ REVISED
SELLING ............................... DOWN
PAYMENT ................................. BALANCE
ON COMPLETION ............. The
installation and equipment above mentioned are subject to the conditions and warranties on the reverse side
ofthis agreement as pertains to the specific equipment involved. These conditions andwarranties constitute a:
factof this agreement. Ole
Installation
Dept. Approval Date: Submitted By"--__..,96. yam--'
By:
Date Acce -teo; ' Credit
Approval Date: Buyer4L _