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Home My WebLink About110 Lee AveCITY OF SANFORD. BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: 1 C) Documented Construction Value: S O Job Address: I 1 L-i e- 4\4-?Xl.la-!Z SCirlVu' YJ 3'Z ( Historic District: Yes No Parcel ID: Zoning: Description. of Work: A)ariGie_ C u.;t a -Van S YcuQ hk 0-ock Plan Review Contact Person: Atyiv lA T-xtw n Title: Phone: Fax: - 2,9i -21031 E-mail:l a broju *&GLC.Q)Or1 Property Owner Information Name :X i1acs. iSS On Phone: Street: to00 E sh Resident of property? City, State Zip:Y b 3'2 Contractor Information Name ')?Kb -TPzk—1 Air C y\X0C 0n SQ Phone: 40 -1-- 1 - l Cca'r 4 Street: Sko"r "QbA. _A Fax: :j n -7 - City, State Zip: Qrkoj/\A o IEL SQY)()4 State License No.: CA-C.O'Z-q Architect/Engineer Information Name: Street: - City, St, Zip: Bonding Company: Address: Building Permit Square Footage: No. of Dwelling Units: Electrical 0 Phone: Fax: E-mail: — Mortgage Lender: Address: PERMIT INFORMATION Construction Type: Flood Zone: New Service - No. of AMPS: Mechanical 9 (Duct layout required for new systems) No. of Stories: Plumbing New Construction - No. of Fixtures: Fire Sprinkler/Alarm 0 No. of heads: 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. 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. 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. 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, pen -nits 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. A copy of the executed contract is required in order to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the plan review fee based on past permit activity levels. Should calculatedcharges - exceed the documented construction value when the executed contract is submitted, credit will be applied to your permit fees when the permit is released. 0/ o Signature of Owner/Agent Date Signature of Contractor/Agent Date Al UQ-Z Print Owner/ Agent's Name Signature Notary - State of Florida Date enauaappejneeeepleaaeeneeea W ILLIAM CHARNLEY Camm#DD0832075 Owner/ Agent is ' gall lto e or Produced IDofIMridaNotary Assn,;ric e. APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: FIRE: Print C trac r/ Agent's Name Signature of N ' ary Stated f;A&Y , MEISEN NOTARY PUBLIC STATE OF RORIDA Comm# DD0936897 Expires 10/ 29/2013 Contractor/Agent is _)< _ Personally Known to Me or Produced ID Type of ID WASTE WATER: BUILDING Rev 11.08 Central Florida: 2425 Silver Star Road, Orlando, FL 32804'• 407.291.1.644 7F1 The Villages: 1576 Bella Cruz Drive #408, The Villages, FL 32.159 •352.409.9007 I www.protechac.com •service@protechac:com 'Toll-Free:800305.5187 AIR CONDITIONING & NEfTINP SERVICE, INC. State Certified CACO29393 Valid'Until: 6 -7Zolo ^JI Z 6 1 o NAME n/ CITY STAT CELL PHONE ". i PHONE( 3 NAME STREET ADDRESS CITY PHONE ( DAY) CELL PHONE S— if ar Q h—l.I CAr n 2yRbe> 32yHoo3 Fv4cnF z,_co Tons: Outdoor unit # Indoor unit #: See manufacturer's literature specfic, detailed warranty information. Online registration is required for warranty activation. 2' Compressor 1 5 110 Compressor 1 S `10 0 i Parts 1 5 10 Parts 1 5 10 Customer online registration 0 I ' Outdoor coil 1 5 1 10 Outdoor coil 1 5 10 , required for 10-year ' warranty activation. 01 Indoor coil 1 5 10 Indoorcoil1 - 5 10 Labor 1 2 Labor 1 2 - J .. _.. ___.-_ ..-..__. t.__.. .__.. -.._. i CUSTOMER INITIAL 1' t Your comfort system will be installed with the highestquality, care & e 100% money back guarantee 100% money back guarantee Workmanship &will comply I 5- year no lemon guarantee 5-year no lemon guarantee with all governing codes El on compressor on compressor & regulations. Pro -Tech guarant_ satisfaction ees your 100% Per ormance guarantee Performance guarantee 24 hours a day, 7 I Installation guarantee 0 Installation guarantee days a week, 365 days a year. STATE ZIP PHONE (EVENING E-MAIL 11P-1 AIR CONDITIONING & HEATING SERVICE, INC. Valid Until l 2010 Customer Name: bes Any new ductwork necessary'to'tonnect the new equipment to the existing duct'system will be constructed of R-6; antimicrobial, UL-approved ductboard. All seams will be sealed with fab mesh & latex mastic for a positive,,durable connection. Balance existing duct system for proper air distribution& inspect for air leaks. Any major duct improvement needed will be proposed & billed separately. Number of supply grilles (additional'charge): Number of return grilles (additional charge): i, Other: a Certified system start-up & installation quality assurance analysis An oversized auxiliary drain pan will be installed with a eon Remove old equipment & installation debris ElAn safety flow switch. Cut & patch any necessary holes at the time of installation Pull all local permits & licenses; call for inspections f Cover floors with drop clothes 1i Comfort Club Membership for year on systems Sweep; dust &vacuum at the end of_each days work j Other: _ — Customer Name: / I r' AIR CONDITIONING & HEATING SERVICE, INC. Valid Until: 1()/-7/Z0/0 — /1 /-7/20/6 Complete system & professional installation Electronic programmable thermostat Trane CleanEffects Media air cleaner Ductwork improvements Electrical upgrades Zoning systems Whole -house dehumidifier Extended warranty Other: Other: Other: I have authority to order the work outlined above. In the event that payment is not made promptly in accordance with agreed terms, it shall be the seller's option to charge a service charge not exceeding 1 'h% a month, the first service charge becoming due I S days from the date of the installation of our amount due on the job. In the event of collection by at- torney, all attorney costs, court costs & other legal fees shall be borne by the buyer. In the event of nonpayment, purchaser agrees to allow seller on premises to remove equipment installed. This investment proposal shall be binding upon the heirs, successor, or assigns of the parties hereto. It is understood that the title to all products & equipment covered by the contract remains solely in the seller until the entire purchase price has been paid in full & the manner of installation and/or attachment to any equipment and/or any portion of the building structure in which the installation is made shall not in any manner jeopardize the sellers title. SIGNATURE: PRO -TECH PR EC MANAGER DATE N2a/o SIGNATURE: WORK AUTHORIZED BY DATE SIGNATURE: WORK AUTHORIZED BY DATE Ii J LIMITER POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: 10 121 1G I hereby name and appoint:\ C axr 1 an agent of: '-R0 --ceoan Ai(- i.Ot'l I-4"Ib r i(lG Name of Company) 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 pen -nits and applications submitted by this contractor. The specific permit and application for work located at: t1 l -Ze, Pikj ZAUX-.C- Street Address) Expiration Date for This Limited Power of Attorney: License Holder Name: —VV jo as, A k Xb n State License Number: (`JAQ f 2g3g3 Signature of License STATE OF FLORIDA COUNTY OFF' p,nj-)U The foregoing instrument was acknowledged before me this `4 d y of 200 0 , by n csoV X0n who isX personally known to me or ? who has produced as identification and who did (did not) take an oath. Signature GRE Y MEISENBUR(3WdIW'f UBLIC Print ameSTATEOFFLORIDA Comm# DDD936897 Expires 10/29/2013 Rev. 3/27/07) Notary Public - State of Commission No. My Commission Expires: CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) CORQ 12/23/2009 PRODUCER 407.886. 3301 FAX 407.886.9530 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION GENTRY INSURANCE AGENCY, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 175 East Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. I PO Box 2046 APOPKA, FL 32704-2046 INSURERS AFFORDING COVERAGE NAIL # INSURED Pro -Tech A/C & Heating Service Inc. INSURERA: Southern Owners Ins. Co. 10190 2425 Silver Star Road INSURERB: Auto -Owners Ins Co 18988 r . Orlando, FL 32804-3311 INSURERC: Bridgefield Employers Ins. Co./Stimmit ; INSURER D: y INSURER E: q COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRLTR DD' NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YYYY POLICY EXPIRATION DATE MW D/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE D OCCUR 72703074 01/01/2010 01/01/2011 EACH OCCURRENCE 1, 000, 000' DAMAGE TORENT D PREMISES Ea occurrence 300,0001 MED EXP (Any,one person) 10,000 PERSONAL & ADV INJURY 1,000,000 GENERAL AGGREGATE 2 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PROJECT LOC PRODUCTS - COMP/OP AGG 2,000,000 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 9543022600 01/01/2010 01/01/2011 COMBINED SINGLE LIMIT Ea accident) 1,000,000X BODILY INJURY Per person) X BODILY INJURY Per accident) X PROPERTY DAMAGE Per accident) GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE AGGREGATE C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Mandatory in NH) If yes, describe under SPECIAL PROVISIONS belowS 0830-29750 01/01/2010 01/01/2011 X TORY LIMITSDERE.L. EACH ACCIDENT 1,000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS COTICI!`ATF' Hni ni=R CANCELLATION City of Sanford Licensing Division Attn: Joanne Johnson P 0 Box 1788 Sanford, FL 32772 25 (2009101) FAX: 407.688. 5251 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE I Debra Liebknecht/LESLIE" re 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD s j