HomeMy WebLinkAbout25102 Northlake Dr 17-312 HVAC (2)ECEIVE
FEB. 01 209
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: 1 f7" 1
c.A
Documented Construction Value: S 3700.00
Job Address: 25102 Northlake Dr. Sanford. FL 32773 Historic District: Yes NoZ
Parcel ID:
Type of Work: New Addition Alteration Repair
Description of Work: hyac changeout to 2 ton 14 seer rnnelrnan
Residential Commercial
Demo Change of Use Move
Plan Review Contact Person: Caytlin Hill Title: Office Manager
Phone: 407-532-8000 Fax: 407-297-7577 Email: caytlin.ameritechflfamail rnm
Property Owner Information
Name Thomas Hallih irton Phone: 813-956-3143
Street: 25102 Northlake Dr Resident of property? : Yes
City, State Zip: Sanford, FL 32773
Contractor Information
Name Ameritech A/C Phone: 407-532-8000
Street: 6290 Edgewater Dr Fax: 407-297-7577
City, State Zip: Orlando, FL 32810 State License No.: CAC1817383
ArchitectlEngineer Information
Name:
Street:
City, St, Zip:
Phone:
Fax:
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. 1 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: S"' Edition (2014) Florida Building Code
Revised: June 30.2013 Permit 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.
t i /ry IV I (SDI 7
Signature of Owner/Agent Date
Print Ownef/Agent's Name
Signature of Notary -State of Florida Date
Date
PringCmnractor/Agent's Name
Icw.k a> t l 30C V-7
Signature oRotary-Stale of Florida _ _ _ Qay
rT— - - - - Stele of fbtltleev"0 NotaryP1
p +; Ceylon :an cG art,g, My Comma
EapUes 07131*020
Owner/Agent is Personally Known to Me or Contr&* e 1 ' Personally Known to Me or
Produced ID Type of ID Produced ID f Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing[-] Gas[] Roof
Construction Type: Occupancy Use: Flood Zone:
Total Sq Ft of Bldg: Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING: FIRE: BUILDING:
COMMENTS:
Revised: Juno 30. 2015
Pemit Application
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Oviedo, Sanford,
Seminole County, Winter Springs
Date: 01/30/17
I hereby name and appoint: Caytlin Hill
an agent of: Ameritech A/C
Name orcompany) 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): All
permits and applications submitted by this contractor. o
The specific permit and application for work located at: 25102
Northlake Dr, Sanford FL 32773 Street
Address) Expiration
Date For This Limited Power Of Attorney: 01/30/18 License
Holder Name: Brian Novotny State
License Number: Signature
of License H, STATE
OF FLORIDA COUNTY
OF Oran The
foregoing instrument was acknowledged before me this 30 day of January , 20
177 , by Brian Novotny who is personally known to me/ or
who has produced as
identification and who did/did not take qn oqh. ge, -
a& P4, 4Signature
Notary
Seal) VA
HEATHER D KELLEY MYCOMMISSION#
FF170MI EXPIRES
October 21. 2018 440.
ffUB-4153 FlorWeNot wl0000m Ideather
I[elloo - Print
or Type Name Notary
Public — State of FL Commission
Number PAK 1 `7 03.G My
Commission Expires: WW== 21, Q 0
Mlr0?I TEE • • .
RE P414 It • REPLACE IT tMMMTtUN IT Work•Orda #
Date: ;A•941 price valid until_w1_ !___
Owner of pmpetty: w S - n I t t l r Cell Phone (g 1 j )
IMF o bows + ON V.Y..)
to -Owner or Tenant: _• _ Cell Phone
Job location.
V__S_
F
Email: C.o r'"t (D Billing Address (if diti'crent):
lye herebypT,vA. install and sere Ic:e under wart artry "(stated below) products or related equSprnent for your home or
hwitess in accordance with the conditions and specifications set forthbelow i dCondenser .
1 PKG HIP® u Other tit
Handier I KW o
Gas Furnace o
Coil — n
AHRW • Tons _,_ daSTEM
SEERRATING I 1wxx1lAt'1?
ir4,kk&116TeRV O Y'rMCoMSt.A,1W1.% PFWn1UNITS) ciftod switch
dGiquid Line.
Suction Use ' 3 oadensate
Pomp,
Ne 1 01Htnv Droln•
Line A/Ge Accept Decline olins set
protective cover ft o Zonbg
Zoo" a Supply
Duet -- o Return
Duct : Dirac ' Ceiling T— SW t
rt
Platform L 9'w+ % v't'1P o Air
Purifier a'rKb
Ffiter type and Sias".` , Y .17T ' Ltr •}c a rill o Drict'
Sanitize: Accept_.Decline ... a Duct
Seal: Accept Dectiue oNew•etemIcaldbeoa"
t tior•.egrideaser o Neu
electrlctll foi.A HU dlsoatrnoct" "• .. - • . o A /
C pad size eT thermostat
type. E ro — T fe • W t . alU work
to be.done in accordance w/esWag code with permitting.. 6
RRemoval
of existing equipmient fromAhe premises. e'AU
workto be performed in a nest and processional manner by
s trained teebnlcisrla. AD debris• removed from premises each
day. •"AmeriTeeb will goaranteeth4;inateil of the product &&-from
defocts in w"h=nshfp for ] (oriel year tram date of
Install. e-Kaai&
ctarer wairanty.oa partti'.•I•b peats..Condenser and Alt
Baisdler. Atnertfec6 w1UVg0Aw w/arraaty paPentorL- atter payment
ii full Sad peradi is ooatpTele: Customer must contact Ameri'
1'ecb it w- arranty ceritltoteb not received within 45 nays
of install• .. o Purchase
extended msnufactnre labor Warr" years: Condenser
and Air Handler.. o: Warranty
on z.;N ft eLectried o Warranty
on dampers Msrnufacturer warranty
on compressor years. Amerizkb venl.
fibe:warranty paperwork suer paymew-hi tall grid ptrmlt:
b complete ,Customer most.eoetact AmeOTOb if w artaaty
eertUieatd is not received widdu 0-doyc oflastall. o,Warrsnly.
oa ductwork a Warr .
41y,on•other _ a•Uiility;
Ctimpagy.• . .. , . . 9,Suso
Protector ' • ;_,r More plejsafbtiow guideGnca•for towl imitY n8 !tH r.. teiieciited
in
w rid4 pursuant ceemlu;tbeie' /B1rL . rlJe aslitaddea!oQedt, mdndiegtD6{oaa•il ileotidivas twee4 x.. uiliiei
erred°to as "Ainerl Lech CoRttiicfota:'W:C dfbfi!Amerl'Lee1 i+IriCoq li0.n i!4!P R4°,5 ! a dD oetto tbo lgws to citcct to ike suite of8. $}'ot. io eeiy.
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a ir
Certificate of Product Ratings
AHRI Certified Reference Number: 8655532 Date: 1/27/2017
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: GSX140241 L•
Indoor Unit Model Number: ARUF29B14A1
Manufacturer: GOODMAN MANUFACTURING CO., LP.
Trade/Brand name: GOODMAN; JANITROL; AMANA DISTINCTIONS; EVERREST; ONE HOUR AIR
CONDITIONING AND HEATING; ENERGI AIR; FRANKLIN
Region: Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA
AK, CO, CT, ID, IL, IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ,
NY, OH, OR, PA, RI, SD, UT, VT, WA, WV, WI, WY, U.S. Territories)
Region Note: Central air conditioners manufactured prior to January 1, 2015, are eligible to be
installed in all regions until June 30, 2016. Beginning July 1, 2016, central air conditioners
can only be installed in regions) for which they meet the regional efficiency requirement.
Series name: GSX14
Manufacturer responsible for the rating of this system combination Is'GOODMAN MANUFACTURING CO., LP.
Rated as follows in accordance with•AHRI Standard 2101240-2008 for. Unitary Air -Co nditioning.a'nd Air -Source
Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored; independent; third
party testing::
Cooling* Capacity (Btuhj: "23600,
EER Rating (Cooling):.: 11.50
SEER Rating (Cooling):' ' " " 14.00' '
IEER Rating (Cooling):
Ratings followed by an asterisk (•I Indicate a voluntary rorete of previously published date. unless s000enponlod with a WAS. which indicates an involuntary carets.
DISCLAIMER
ANRI does not endorse the product(*) listed on this Certificate and makes no representatiom warranties or guarantees as to, and assumes no responsibility for.
the product(s) listed on this Certificate. ANRI expressly dlsdalms all liability for damages of any kind arlsIng out of the use or performance of the product(sL or the
unauthoAted alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed In the
directory at www.ahridirectory.org.
TERMS AND CONDITIONS AllThisCertificateandItscontentsareproprietaryproductsofANRI. This Certificate shall only be used for Individual, personal and
confidential reference purposes. The contents of this Certificate may not. In whole or in part, be reproduced: copied. disseminated;
entered Into a computer database; or otherwise utilized, In any form or manner or by any means, except for the user's Individual.
personal and confidential reference. AIR-CONDITIONING, NEATINO,
CERTIFICATE VERIFICATION 6 REFRIGERATION INSTITUTE
The Information for the model cited on this certificate can be verified at www.shridiroctory.org. dick on -Verify Certificate' link wo make ilk• lR eenl-
and enter the ANRI Certified Reference Number and the date on which the certificate was Issued.
which Is listed above, and the Certificate No., which Is listed at bottom eight
13130024649465541
02014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: