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Home My WebLink About100 Cabana View WayI { cmi V; ED JUL -,,,6 2015 F , D j BY: CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: d 3 Documented Construction Value: $ ' 1 - Job Address: _ W2 " a- i /l no i oau Parcel ID: SCI-/-1 } - 31-56, - 6W6- U5 O Description of Work: k Plan Review Contact Person: e' '10 Phone: qn-3Sr-i'-<Q6b( Fax: Historic District: Yes No Zonin Titles: al'/''1 I E- mail: l) v-!h?Qy'1C'li/! v no/ Property Owner Information ( Name 61 C-)cr-CK-0- Phone: "_ - -7 Street: / DD CA b ' r- ut e V3 W c,_ H/' Resident of property?: City, State Zip: Contractor Information 2 Name uuirai, Air `if 174rto Phone: '1 C, ( - 35cl - eiScs i Street: - l'n OG - Fax: City, State Zip: C IOI,P (/% _ (D State License No.: 0"01Uq'91 93Y Name: Street: City, St, Zip: Bonding Company: Address: Building Permit Square Footage: No. of Dwelling Units: Electrical Architect/ Engineer Information Phone: Fax: E- mail: Mortgage Lender: Address: PERMIT INFORMATION Construction Type: No. of Stories: Flood Zone: New Service - No. of AMPS: Mechanical (Duct layout required for new systems) Plumbing New Construction - No. of Fixtures: Fire Sprinkler/ Alarm 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 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. 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 calculated charges exceed the documented construction value when the executed contract is submitted, credit will be applied to your permit fees when the permit is released. 19 ,,, Signature of Owner/Agent Date Signature Contra or/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 APPROVALS: ZONING: ENGINEERING: COMMENTS: UTILITIES: ontractor/Agen 's NamePti1> - 4--, -7 ERIN RASTETTER Notary Public - State of Florida My Comm. Expires Nov 5, 2018 Commission # FF 174479 Borded through National Notary Assn. Contractor/Agent is Personally Known to Me or Produced ID Type of ID WASTE WATER: FIRE: BUILDING: Rev 11.08 MAIN OFFICE: INSTALLATION AGREEMENT American Air & Heat, Inc. Amenem 502 S. Econ Circle, Oviedo, FL 32765 • { DATE 407.359.9501 • Fax 407.359.9504 1.800.421.000L (2665) µkw. FL ucncrlc oavza.• AmericanAirAndHeat.com CUSTOMERNAME , ` J f• `° JOB LOCATION h71CITY _ST ZIP - r HOMEPHONE t- / 4 CELL EMAIL BILLTO CITY Sr ZIP EQUIPMENT•.D A/C 04ATPUMP CONDENSER HTR/COIL (t % AIR HANDLER SYSTEM 1 t f'v F./ S ''%r"" SEER SIZE /Z/ 1-2w1'1e Cj t' t/ ' SYSTEM 2 SEER SIZE w - f•/ i' 7 w SCOPEOFWOR r1r ice/ t r/r /• . A ,.a fe 1 ' bra NEW INDOOR DISCONNECT NEWOUTDOOR DISCONNECT NEWWIREWHIPS NEW LOW VOLTAGE WIRING 12NEW HURRICANE STRAPS B' 4EW REINFORCED EQUIPMENT PAD NEW CONDENSATE DRAIN LINE NEW REFRIGERANT LINESET O-INSULATE REFRIGERANTSUCTION LINES O'INSTALL REFRIGERANT DRIER(S) O'EVACUATE REFRIGERANT SYSTEM 12 -11 FLUSH KIT COMFORTCONCERNS DUCTCALCULATION (MANUAL D) REPLACE SUPPLY PLENUM REPLACE RETURN PLENUM 2 RECONNECT SUPPLY/ RETURN O'R`E- LINE PLATFORM O'PLATFORM TOP NEW SUPPLY DUCT( S) NEW RETURN DUCT( S) SEALDUCTSYSTEM REPLACE DUCT SYSTEM OrMASTICANDSEALALLPLENUMS O`FLUSH CONDENSATE DRAIN LINES AUX. DRAIN PAN W/ SAFETYSWITCH B'NEW CONDENSATE O/FSAFETYSWITCH NEWCONDENSATE PUMPW/ SAFETYSWITCH M/C VISA DISC D AMEEX CAASH CHECK# 0,FINANCING (SAC/ MO) ` ,, / '" OTHER ADDITIONAL INFO" O POWER CO. # CREDITAMOUNT All material is guaranteed to 6e as specified. All work to 6e completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving in extra costs will 6e executed only upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents, delays beyond our control or Acts of God. Owner to carry fire, tornado, and other necessary insurance. Our workers are fully covered 6y Workman's Compensation insurance. Owner hereby waives his insurance company's right of subrogation and waiver continues after completion of contract NOTE: It is agreed and understood 6y the parties that all equipment and parts which are sold pursuant hereto shall NOT become fixtures or part of the real estate where they are placed. Said parts and equipment shall at all times remain personal property of American Air & Heat, Inc. until payment in full is received. Buyer hereby agrees that all parts and equipment may 6e repossessed in the even of non-payment Systems are sized based on Manual J heat load calculations. The conditions for this calculation are 95 degrees outdoor and 75 degrees indoor temperatures as per equipment design specifications. American Air & Heat accepts no responsibility for customers attempting to operate systems outside these desien conditions. This proposal is valid for 30 days unless otherwise specified HEATLOAD CALCULATION (MANUALJ) INSULATION INSPECTION 19, MISC/OTHER ";," D'fHERMOSTAT ErHIGH EFFICIENCY FILT y 0-NEWUVAIRPURIFIER / 7 OIMEETALLCODE REQUIREMENTS 04EMOVALOFOLD EQUIPMENT la• CLEAN WORKAREATO CUSTOMER SATISFACTION DISTART UP SYSTEM YEAR LABOR WARRANTY Id YEARWARRANTYON ALL FUNCTIONALPARTS YEAR WARRANTY ON COMPRESSOR PEACE OF MIND GUARANTEES 11 COMFORTSYSTEM INVESTMENT FPLREBATES MANUFACTURER REBATE SERVICE INVOICEAMOUNT A ERICAN AIR & HEAT jPROMOTION i MONTHLYINVESTMENT MOS. NET INVESTMENT PRICE, HOME WNERAUT ORIZATION AMERICANAIR & HEATAUTHORIZATION itl:4_ '" DATE' ` 9 r /J)fJ"r / 'd/I DATE L. a< Fam4-{ ri&4 servZm7Wa .. A1rier1C In AAWU04ARer.03/15 ,, ' R/O MBF 407-657-7414 This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2014. Certificate of Product Ratings AHRI Certified Reference Number: 6936859 Date: 7/2/2015 Product: Split System: Heat Pump with Remote Outdoor Unit -Air -Source Outdoor Unit Model Number: 25HCB648A**31 Indoor Unit Model Number: FV4CN(B,F)005L Manufacturer: CARRIER AIR CONDITIONING Trade/Brand name: CARRIER AIR CONDITIONING Series name: PERFORMANCE 16 PURON HP Manufacturer responsible for the rating of this system combination is CARRIER AIR CONDITIONING Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air -Conditioning and Air -Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third party testing: Conlin' g Capa city"_(Btuh)=-D 47000 `' Q EER'Rg (Cooli )- 12J 0 { SEERating _(Cooling):' 16100 Heating Capacity(Btuh) @ 47 F: 46500 / Region IV HSPF Rating (Heating): 9.00 Ratings followed by an asterisk (') indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed In the directory at www.ahridlrectory.org. TERMS AND CONDITIONS This Certificate and Its contents are proprietary products of AHRI. 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; AMenteredIntoacomputerdatabase; or otherwise utilized, in any form or manner or by any means, except for the user's Individual, personal and confidential reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The Information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link we make life better, and enter the AHRI 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 right. 2014 Air -Conditioning, Heating, and Refrigeration Institute 1 ® ACORQ- CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYl'Y) 2/23/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements . PRODUCER Blackadar Insurance Agency, Inc. 1436 N Ronald Reagan Blvd Longwood FL 32750 CONTCTNAME: A Pat DiPietro PHONE FAX No E-MAILADDRESS: INSURERS AFFORDING COVERAGE NAIC S INSURERA-Addoson Insurance Company 10324 INSURED AMERAI R-01 INSURERB:FFVA Mutual Insurance Company 10385 C:Old Republic SurelyAmericanAir & Heat, Inc. INSURER D : 502 S. Econ Circle Oviedo FL 32765 INSURER E INSURER F : rnvGoerFs CFRTIFICOTF NIIMRFR- 1r0177r,'%RO REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRLTR TYPEOFINSURANCE ADDL SUBR POLICYNUMBER POLICY EFF MMIDD POLICY EXPWMMIDDIYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FTI OCCUR 60362417 712212014 22/2015 EACH OCCURRENCE 1,000,000 DAMAGE TOPREMISESEaEoccurrence) 100,000 MED EXP (Any oneperson) 5,000 PERSONAL & ADV INJURY 1 000 000 GENERAL AGGREGATE 2.000.000 GEN' L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS - COMPIOPAGG 2,000,000 A AUTOMOBILE LIABILITY X ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS HIRED AUTOS AUTOSNON-OWNED 60362417 22/ 2014 22/2015 INULE LIMIT Ea accident 1 000 000 BODILY INJURY ( Per person) S BODI LY INJURY (Per accident) PROPERTY DAMAGE Per accident S S UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS - MADE EACH OCCURRENCE AGGREGATE S DED RETENTIONS B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/ PARTNER/EXECUTIVE a OFFICER/MEMBEREXCLUDED? Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC84000170502014A 22/ 2014 22/2015 X WC STATU- OTH- ER E.L. EACH ACCIDENT 100,000 E.L. DISEASE - EA EMPLOYEE 100,000 E.L. DISEASE - POLICY LIMIT 1 $500.000 C Business Services Bond OBS0539627 17/2015 17/2016 Limit $25,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Blanket Additonal Insured with respect to the General Liability when required by contruction agreement and Business Auto when required by written contract. Blanket Waiver of Subrogation applies to Workers' Compensation and Business Auto when required by written contract. GtK I IrIUA I t HULU CITY OF SANFORD P.O. BOX 1788 SANFORD FL 32772-1788 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. W 1U? Jt1-ZU1U AUVMLP %,UMrVrL-kI IVIV. /All r19IILS IrJCIVCU. ACORD 25 ( 2010105) The ACORD name and logo are registered marks of ACORD UC I/At- ri r1CKC RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA ' ISSUED: 06/15/2014 DISPLAY AS REQUIRED BY LAW SEQ # L1406150001591 SE1MINOLE COUNTY BUSINESS TAX RECEIPT RAY VALDES, SLMI TOLE COUNTY TAX COLLECTOR PO Box 630 ® Sanford, FL 32772-0630 ® Telephone: 407-665-1000 www.seminoleta,-i.org VALID THROUGH 09/30/15 AMERICAN AIR & HEAT INC 502 S ECON CIR OVIEDO, FL 32765 MATTHEW A BONI (OFFICER) Account #:067018 REGULATED License # - CMC049238 Qualifier- JERRY BENT I Receipt #: OLHS2014081801092 Amount Paid: $ 45.00 ' Date Paid: 08/18/2014 j LIMITED POWER OF ATTORNEY Date -7/aIIri r I hereby name and appoint An agent of: American Air and Heat To be my lawful attorney —in-fact to act for me to apply for, receipt for, and sign for and do all things necessary to this appointment for: R-ha-g-a— Address of Job) IExpirationdateforthislimitedpowerofattorney: - gnature of Certified Contractor) Jerry Bent, CMC049238 Printed Name of Contractor and License Number) State of F rida County o I A " tand sub ribe before me this Q day of V i'by I Who is personally known to me who has produced (identification) Notary Seal) ic Commission expires: 3r/ H, 0 a k, cf Print or Type Name) ERIN RASTETTER o Pn Y60, da Notary Public -State of FIo2rI018Nov5, My Comm. Expires FF 17447Acommission Bonded through National Notary Assn' Permit Number: III I6111 ilili illll illll lllli liil III Folio/Parcel 1D4• 6( G - (-501•-COvp O Prepared by: - r.V1 / - Hrn Return to: I'MIRYr)NNE 110PNSEP SEMINOLE COUNTY CLERK OFF C7RCL17.1 COURT & CnrIPTROLLER BK 158, ) CLERK':; .x 2015072492 RECORDED 07/06/2015 Fri RECORD114G FEES $10.00 I;ECORDED BY hdevore NOTICE OF COMMENCEMENT State of Florida, County of Orange The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Description of property (legal despr'ption of the property, and street address if available) n• lei . 2. General description of im i 3. Owner i9formaion or Lessee Name MA bG1CCI•G— the improveme Interest in Propertyit3GL)1 L.4.K Name and address of fee simple titleholder (if different from Owner listed above) Name Address 4. Contractor Name ICG'l.t' '• Telephone Number -nSC}1 Address e- 0,-1 G rvi4eko ' T'L % 7, ' ,5 5. Surety (if applicable, a copy of the payment bond is attached) Name Telephone Number Address Amount of Bond $ 6. Lender Name Telephone Number Address 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by §713.13(1)(a)7, Florida Statutes. Name - Telephone Number Address 8: In addition to himself or herself, Owner designates. the following to receive a copy of the Lienor's Notice as provided in §713.13(1)(b), Florida Statutes. Name . Telephone Number Address 9. Expiration date of notice of commencement (the expiration date may not be before the completion of construction and final payment. to the contractor, but will be 1 year from the date of recording unless a different date is specified). WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT • ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE REC DED 'D POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT W T OUR DER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. gnat a of wner or Lessee, or Owner's or Lessee's Authorized Officer/Director/Partner/Manager Sig atory's Title/Office The f re oing instrument was acknowledged before me this ' day of j t,, —%1 Rovoa ovo, onth/ year natng of person as ' for pe of authority, e g office t ustee, attorney in fact Nar ofparty on beha f who ins ru ent was executed 1; 4 UAA gnature of Notary Public — State of Florida Print, type, or stamp commissioned name of Notary Public ERIN RASTETTER Personally Known' Produced ID gaeYHFroGff/ ;?o,^R"P"a,'-, Type oft Produced _ _,_ • 9,. = Notary Public •state bl flbrf aRSE %` •os i • ; •= My Comm. EXplrea Nov 5, 201A vu v n rtrvu :? Commission # FF 174479 C0 -PTROLLE i s'.., e' : SEMfNV° NTY 'LORIDA 4 ytt"t Nsw^ °. 8nrded through National Notary Assn JUL U ZO1 .. BY DEPUTY CLERK