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HomeMy WebLinkAbout1804 Washington Avet toil -III.. FEB 1 Y 2016 CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: I % DS Documented Construction Value: $ Job Address: I O koho le Historic District: Yes NoM Parcel ID: 3-'/ l " 3 "SU -J %d Residential Commercial Type of Work: New Addition AlterationRepair Demo Change of Us Move Description of Work: Plan Review Contact Person: L Title: rt Phone: aI ZZ7-?7/5- Fax: 70- -/ .315 Email: L ACII7Q ' e.• Property Owner Information Name /ii4ifie/ A9//fjL° s Street: gd AOL(111 44 %e. City, State Zip: //, 1q, .3Z 77/ Phone: Resident of property? : 0ll//ie . Contractor Information Name A r 44weh 1yG Y! Phone: ,%" 7, ,/, -a 77A/ Street: tW9' A 171 S e ' p- Fax: D% ZZO /,3.30 City, State Zip: 469 `( G 2 State License No.: Arch itectlEngineer Information C'fe-, Name: Street: City, St, Zip: Bonding Company: Phone: 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 Rrvicp& Time If) 901 S Permit Annliratinn MAIE A/ NOTICE: Iu 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 a ate aye at all work will be done in compliance with all applicable Ia s regulating construction A zoo ng,•' - 7 Signature of Owner/Ag t r Da Signature of o or/ geQi/ Date Print Owner/Agent's Name Print Contiktor/AgentlrrName Signature of otary- t Owner/Agent is Produced 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: of Heads UTILITIES: FIRE: Flood Zone: of Stories: Plumbing - # of Fixtures, Fire Alarm Permit: Yes No WASTE WATER: BUILDING: Rrvicrrl• Linn 4n 7ni S Prnnit Annlinntinn Pat Lynch Construction 909 Dennis Ave Orlando, FL 32807 NOTICE TO PROCEED Subject: IFB Contract for NVAC Services for Residential Properties. PO # 37548 *** Total Order $ 5,820.00 Address:1804 Washington Ave Sanford Fl. Parcel ID #: 31-19-31504-0300-0200 z9Contactperson: Marie Barnes Phone Number: 407-284-7091 The services provided by our firm shall begin on 112712016 and shall reach final completion 30 days from Notice To Proceed, as described in the contract documents. The timely and accurate performance of the work set forth in the contract documents is important to the County. It is also a primary consideration for the contractor selections on future projects. Please acknowledge below, retain a copy for your records and return the original to the Seminole County Community Development Office. Do not start the job until the required permits have been obtained and the work scheduled. Please email a digital copy of HVAC permit to: isandlev@seminolecountvfl.gov Upon completion, please notify the Construction Project Manager and submit a copy of the inspection final. We are glad to have you as part of the County's project team and we look forward to a successful project. Sincerely, Construction Project Manager CommunityDeve%pment Seminole countyGovemment Phone: 407-665-2376 Fax. 407-6652399 WKIRSemin016CO11B PA9OF ACCEPTANCE OF NOTICE reby acknowledged, this i ? day of SCPA Parcel View: 31-19-31-504-0300-0200 http://www.scpafl.org/ParcelDetaillnfo.aspx?PID=311931504030... Cltrvld.Johnstoa,C.FA Property Record Card PR®P t Parcel: 31-19-31-504-0300-0200 APPRAISER Owner: BARNES MARIE L SEMVJOIECOTYFLORIDA Property Address: 1804 WASHINGTON AVE SANFORD, FL 32771-3905 Parcel:31-19-31-504-0300-0200 I Property Address: 1804 WASHINGTON AVE Owner: BARNES MARIE L Mailing: 1804 WASHINGTON AVE SANFORD, FL 32771-3905 Subdivision Name: BEL-AIR SANFORD Tax District: Sl-SANFORD Exemptions: 00-HOMESTEAD (1994) DOR Use Code: 01-SINGLE FAMILY Legal Description LOT 20 (LESS N 16 FT) & N 25 FT OF LOT 21 BLK 3 BEL-AIR PB 3 PG 79 & 79A Taxes Value Summary 2016 Working Values 2015 Certfied Values Valuatlon Method Cost/Market Cost/Market Number of Buildings 1 Depreciated Bldg Vatre - $-28,662 1 28,778 2,856 - Depreciated EXFT Value $2,856 - - Land Value (Market) $10,579 10,579 Land Value Ag — Just/Market Value , 2 097 Portabity Adj 42,213 Save Our Homes Adj 1,391 1,790 Amendment 1 Adj 40,423AssessedValue40,706 Tax Amount wtiwut SOH: 266.39 2015 Tax Bil Amount 238.69 Tax Estimator Save Our Homes Savings: 27.70 Does NOT INCLUDE Non Ad Valorem Assessments Taxing Authority Assessment Value Exempt Values Taxable Value County General Fund Srh0015 — -- — City Sanford 40,706 $40,706 40,706 l --- $25,000 40,706 ; $25,000 0 15,706 15,706 SIWM(Saint johns Water Management) 40,706 $25,000 15,706 County Bonds 40,706 $25,000 15,706 Sales Descr"on Date Book Page Amount Quailied Vac/Imp WARRANTY DEED 6/1/1993 02609 0179 $43,700 t Yes Improved WARRANTY DEED 6/1/1981 01343 01222 0509 ` $28,000 Yes 0795 $17,800 Yes Improved WARRANTY DEED 15/1/1979 Improved Find Comparable Sales v&M this Subdivision Land Method Frontage Depth units Units Price Land Value FRONT FOOT & DEPTH 65 1 125 j 0 , $175.00 1 $10,579 Building Information 1 of 2 1/28/2016 11:47 AM w i "wRiopgR 1 m1 AL Right J® Mobile Report D Entire House For: Marie Bames 1804 Washington Avenue, Sanford, FL 32771 7P_Sinn Conditir Job: Date: 1/28/2016 By: Location: Indoor: Heating Cooling Orlando Sanford AP, FL, US Indoor temperature (°F) 70 75 Elevation: 52 ft Design TD (°F) 29 18 Latitude: 29°N Relative humidity (%) 30 50 Outdoor: Heating Cooling Moisture difference (gr/lb) 2.4 37.7 Dry bulb (°F) 41 93 Infiltration: Dailyrange (°F) - 17 ( M) Method Simplified Mtbulb (°F) - 75 Construction quality Average Wind speed (mph) 15.0 7.5 Fireplaces 0 Component Btuh/ft2 Btuh of load Walls 4.1 4102 30.5 Glazing 16.5 1901 14.1 Doors 17.4 832 6.2 Ceilings 1.4 1385 10.3 Floors 3.2 3133 23.3 Infiltration 1.8 2095 15.6 Ducts 0 0 Piping 0 0 Humidification 0 0 Ventilation 0 0 Adjustments 0 Total 13460 100.0 Cooling Component Btuh/ft2 Btuh of load Walls 2.8 2758 17.8 Glazing 39.3 4516 29.2 Doors 18.4 881 5.7 Ceilings 2.2 2112 13.6 Floors 2.0 1934 12.5 Infiltration 0.6 661 4.3 Ducts 0 0 Ventilation 0 0 Internal gains 2630 17.0 Blower 0 0 Adjustments 0 Total 15492 100.0 Latent Cooling Load = 1060 Btuh Overall U-value =0.184 Btuh/ft22F Data entries checked. Ga irg firs Ceilings wri htsoft- 2016-Jan-2811:20:20 Q Right -Suite® Universal 2015 15.0.23 Right A Mobile Page 1 wstmp182d9e7b3-6918-4f28-b4elc125f4d7bda6.rup Calc=MJS FrontDoorfaces: N AL Project SummarydEntireHouse For: Marie Barnes 1804 Washington Avenue, Sanford, FL 32771 Notes: Weather: Orlando Sanford AP, FL, US Job: Date: 1/28/2016 By: Winter Design Conditions Summer Design Conditions Outside db 41 °F Outside db 93 °F Inside db 70 °F Inside db 75 °F Design TD 29 °F Design TD 18 °F Daily range M Relative humidity 50 % Moisture difference 38 gr/lb Heating Summary Structure 13450 Btuh Ducts 0 Btuh Central vent (0 cfm) 0 Btuh Humidification 0 Btuh Piping 0 Btuh Equipment load 13450 Btuh Infiltration Method Simplified Construction quality Average Fireplaces 0 Heating Cooling Area (ft) 975 975 Volume (ft) 8775 8775 Air changes/hour 0.45 0.23 Equiv. AVF (cfm) 66 34 Heating Equipment Summary Make Rheem Trade RHEEM Model RP1524BJl NA AHRI ref 8204599 Sensible Cooling Equipment Load Sizing Structure 15492 Btuh Ducts 0 Btuh Central vent (0 cfm) 0 Btuh Blower 0 Btuh Use manufacturers data y Rate/swing multiplier 1.00 Equipment sensible load 15492 Btuh Latent Cooling Equipment Load Sizing Structure 1060 Btuh Ducts 0 Btuh Central vent (0 cfm) 0 Btuh Equipment latent load 1060 Btuh Equipment total load 16552 Btuh Req. total capacity at 0.70 SHR 1.8 ton Cooling Equipment Summary Make Rheem Trade RHEEM Cond RP1524BJlNA Coil RBHP-17AOONHI AHRI ref 8204599 Efficiency 8.5 HSPF Efficiency 12.5 EER, 15 SEER Heating input Sensible cooling 15960 Btuh Heating output 20600 Btuh @ 47°F Latent cooling 6840 Btuh Temperature rise 25 °F Total cooling 22800 Btuh Actual air flow 760 cfm Actual air flow 760 cfm Air flow factor 0.057 cfm/Btuh Air flow factor 0.049 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat Load sensible heat ratio 0.94 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. wrightsoft• RightSuite6Universa12015 15.0.23 Right A Mobile 2018-Jan-2811:20:20 Page 1 lwstmpt82d9e7b3-6918-4f28-b4elc125f4d7bda8.rup Celc = MJ8 Front Door faces: N Right-M Worksheet Job: Entire House Date: 1/2812016 By: AL 1 Room name Entire House First Floor 2 Exposed wall 128.0 ft 128.0 ft 3 Room height 9.0 ft d 9.0 ft heat/co01 4 Room dimensions 39.0 x 25.0 It 5 Room area 975.0 ft' 975.0 ft' T y Construction U-value Or HTM I I Areaft' Load I Area ft' I I Loadnumber Btuh/fN-° F) Btuh/ft') or perimeter (it) Btuh) or perimeter (ft) Btuh) Heat Cool Gross N/P/S j Heat I Cool j Gross I N/P/S j Heat Cool 6 13A-400cs' —' 0.143 n 4.15 2.79T 351 289 1199 80 ' 6 951 289 1199 666 G 1 Dc2ow 0.570 n 16.53 21.90 35 0 579 767 35 0 579 767 11J0 _y_- _ v 9.600 n _ 17.40 18^42 27 27 N _467 494 V 27 V 467 494 wrr-- 13A-40cs 0.143 a 4.15 D9 225 182 753 506 225 182 753 506 11 1 Dc2ow 0.570 a 16.53 63.98 23 0 372 1440 23 0 372 1440 c- D 11JO V_ 0.600 e _ 17.40 18.42 21 21 365 387 21 21 365 387- y/ 13A-40cs 0.143 s 4.15 2.79 351 316 1310 881 351 316 1310 881 G 1D-c2ow,_._ 0.570 s 16.53 24.86 35 0 579 870 35 0 579 870 V)/ 13A-4ocs 0.143 w 4.15 2.79 225 203 840 565 225 203 840 565 G ID-c2ow 0.570 w 16.53 63.98- 23 0 372 1440 23 0 372 1440 C_. __ 16C-19a1. - - 0.049 1.42 2.17. 975, 975 1385 2112 975 975 1385 2112 F 19A-0cscp _ 0.295321 1.98 975 975 3133 1934 975 975 3133 1934 61 c) AED excursion 0 10 Envelope loss/gain 1 113541 122011 1 1 113541 12201 12 a) Infiltration 2095 661 2095 661 b) Room ventilation 0 0 0 0 13 Internal gains: Occupants Q 230 1 230 1 230 Appliances/other 2400 2400 Subtotal (lines 6 to 13) 13450 15492 13450 15492 Less external load 0 0 0 0 Less transfer 0 0 0 0 Redistribution 0 0 0 0 14 Subtotal 13450 15492 13450 15492 15 Duct loads 0 %j 0 0 0% 0% 0 0 Total 13I 760 15I 76013 76015 760 irrequired() I IIIIICalculationsapprovedby ACCA to meet all reauirements of Manual J 8th Ed. wrightsoftr 20 Right - Suite® Page Universal 15.0.23 Right J® Mobile 2016Jan-Jan 1 wstmpXB2d9e7b3.6918- 4f28- b4elc125f4d7bda6.rup Calc=MJ8 FrontDoorfaces: N AL p Component Constructions Entire House For: Marie Barnes 1804 Washington Avenue, Sanford, FL 32771 Location: Orlando Sanford AP, FL, US Elevation: 52 ft Latitude: 29 °N Outdoor: Heating Dry bulb (T) 41 Dailyrange (T) - Wet bulb (° F) - Wind speed (mph) 15.0 Indoor: Indoor temperature (T) Design TD (°F) Relative humidity (%) Cooling Moisture difference (gr/lb) 93 Infiltration: 17 ( M) Method 75 Construction quality 7.5 Fireplaces Job: Date: 1/28/2016 By: Heating Cooling 70 75 29 18 30 50 2.4 37.7 Simplified Average 0 Construction descriptions Or Area U-value Insul R Htg HTM Loss Clg HTM Gain r Btuh/R'--T W-"FAXuh Btuhl0.' Btuh BhhIIP Btuh Walls 13A-4ocs: Blk wall, stucco ext, r-4 ext bd ins, 6" thk, 1/2" gypsum n 289 0.143 4.0 4.15 1199 2.79 806 board int fish a 182 0.143 4.0 4.15 753 2.79 506 s 316 0.143 4.0 4.15 1310 2.79 881 w 203 0.143 4.0 4.15 840 2.79 565 all 989 0.143 4.0 4.15 4102 2.79 2758 Partitions none) Windows 1 D-c2ow: 2 glazing, clr outr, air gas, wd frm mat, dr innr, 1/4" gap, 1/8" thk; 6.67 ft head ht Doors 11JO: Door, mtl fbrgl type Ceilings 16C-19al: Attic ceiling, asphalt shingles roof mat, r-19 ceil ins, 1/2" gypsum board intfnsh Floors 19A-Ocscp: Fir floor, wd flr, 1" thkns, carpet fir fish, tight crwl ovr n 35 0.570 0 16.5 579 21.9 767 e 23 0.570 0 16.5 372 64.0 1440 s 35 0.570 0 16.5 579 24.9 870 w 23 0.570 0 16.5 372 64.0 1440 all 115 0.570 0 16.5 1901 39.3 4516 n 27 0.600 6.3 17.4 467 18.4 494 e 21 0.600 6.3 17.4 365 18.4 387 all 48 0.600 6.3 17.4 832 18.4 881 975 0.049 19.0 1.42 1385 2.17 2112 975 0.295 0 3.21 3133 1.98 1934 2016 Jan 2811. tc wrightSoft• Right-Sulle® Universal2015 15.0.23 Right A Motile Page 1AM ...\wstmp182d9e7b3.69184f28-b4e1-c125f4d7bda6.rup Calc=MJ8 Front Door faces: N AL AED Assessment Entire House e-roject intormation For: Marie Barnes 1804 Washington Avenue, Sanford, FL 32771 Job: Date: 1/28/2016 By: Design Conditions Location: Indoor: Heating Cooling Orlando Sanford AR FL, US Indoor temperature (°F) 70 75 Elevation: 52 ft Design TD (°F) 29 18 Latitude: 29°N Relative humidity (%) 30 50 Outdoor: Heating Cooling Moisture difference (grAb) 2.4 37.7 Dry bulb (°F) 41 93 Infiltration: Dailyrange (°F) - 17 ( M Wet bulb (°F) - 75 Wind speed (mph) 15.0 7.5 Test for Exposure Hourly Glazing Load 10 11 12 13 14 15 16 17 18 19 20 Hour of Day Hourly / Average /limit Maximum hourly glazing load exceeds average by 18.5%. House has adequate exposure diversity (AED), based on AED limit of 30%. AED excursion: 0 Btuh wri htsoft• 2016-Jan-2811:20:20 y g Right -Suite® Universal 15.0.23 Right J® Mobile Page 1 l G...\wstmp182d9e7b3-6918-4f28-b4e1-c125f4d7bda6.rup Calc=MJ8 FrontDoorfaces: N First Floor First Floor Job #: Performed for: Marie Bames 1804 Washington Avenue Sanford, FL 32771 AL Scale: 1 : 65 Page 1 RightSuite® lh iversal 2015 15.0.23 Right J® Mobile 2016-Jan-28 11:20:20 6918-4f28-b4e1-c125f4d7bda6.rup City of Sanford HVAC Permit Application Checklist 111 D All permit application packages must be complete prior to acceptance. You must check each 4V - box to the left or indicate n/a on this submittal. A complete application package shall include the following: Building Permit Application completed, signed and notarized. Application must include correct address and complete parcel I.D. number. 0 Copy of applicable contractor's license issued by the State of Florida (if the contractor is the applicant). t A site specific notarized power of attorney shall be required from the licensed contractor if he/she appoints an employee of his/her company to sign the permit application as the contractor. Certificate of insurance indicating worker's compensation insurance coverage and naming the City of Sanford as certificate holder, or a copy of a worker's compensation exemption issued by the State of Florida (must be submitted with each application if contractor is the applicant). Completed and signed Owner Builder Statement / Affidavit (if the owner is the applicant). i One (1) copy of equipment sizing calculations — for new construction installations: o Residential - ACCA Manual J-2003 or other approved heating and cooling calculation methodology. o Commercial - ACCA Manual N-2005 or other approved heating and cooling calculation methodology. These guidelines were compiled to assist the applicant in preparing a DVAC change outpermit application and may not be complete. The applicant is required to meet all City of Sanford, state, and federal code requirements. Revised. March 2014 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDrNM 12/02/2015 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 policy (ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditionsofthepolicy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of suchendorsement(s). PRODUCER CONTACT NAME PHONE A/C, No, Exl : 1.800-277-1620 x4800 FAX =. No : 2 797-0704 E-MAIL ADDRESS: FrankCrum Insurance Agency, Inc. 100 South Missouri Avenue INSURER(S) AFFORDING COVERAGE NAICqClearwater, FL 33756 INSURER A: Frank Winston Crum Insurance Co. 11600 INSURED INSURER B: INSURER C: FrankCrum L/C/F Pat Lynch Construction LLC INSURER D: 100 South Missouri Avenue INSURER E: Clearwater, FL 33756 INSURER F: KI-VI,IUN NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAYPERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWNMAYHAVEBEENREDUCEDBYPAIDCLAIMS. INSRLTR TYPE OF INSURANCE ADINSRO SUERWVD POLICY NUMBER POLICY EFF MMIDDNYYY) POLICY EXP MMIDDNYY`/) LIMITS GENERAL LIABILITY EACH OCCURRENCE S C00.VAERCIIL GENERAL LIABILITY C1,A17.15-btADE OCCUR DAMAGE TO RENTED PRE0.115ES Ea ocwnence S MED EXP(Any one Person) S PERSONAL d ADV INJURY S GENERAL AGGREGATE S GENI AGGREGATE LIMIT APPLIES PER: POLICY PROJECT LOC PRODUCTS-COMPIOPAGG S S AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT M. acddent S BODILY INJURY (Per person) SALLOWNEDSCHEDULEDBODILYINJURY ( Peracddent) S AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per acid-1 S S UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS- NiAGE EACH OCURRENCE S AGGREGATE S DEDIIRETENTIONSS A WEMORKERS COMPENSATION AND PLOYERS'LI1®LTY ANY PROPRIETORIPARTNERIEXECUTNE YIN OFFICE WAEMBER EXCLUDED? Q Mandatory in NH) N/ A WC20160DOD0 01/01/2016 01/01/2017 X we sraMORY UMrTSoTH- ER EL EACH ACCIDENT S1.000A00 EL DISEASE -EA EMPLOYEE S1.0 0A00 Dyes, describeIPTION under DESCRIPTION OF OPERATIONS 6elmr EL DISEASE -POLICY LIMIT S1.00D.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Addldonal Remarks, Schedule, if more space is required) Effective 11/25/2013, coverage is for 100% of the employees of FrankCrum leased to Pat Lynch Construction LLC (Client) for whom the client is reporting hours toFrankCrum. Coverage is not extended to statutory employees. CERTIFICATE HOLDER ........-.... ,... I ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE rION DATETHEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WTH THE PROVISIONS. City of Sanford AUTHORIZED REPRESENTATIVE PO Box 1778 Sanford, FLl- 32772 m 1988-2010 ACORD CORPORATION. All rights reserved. ACORD25 (2010105) The ACORD name and logo are registered marks of ACORD 114 RE)® CERTIFICATE OF LIABILITY INSURANCE DATE(MrAIDONYYI] 12/16/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCt=RTIFICAYE.DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVEORPRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT if the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If'SUBROGATION IS WAIVED, subject totheternsandconditionsofthepolicy, certain policies may require an endorsement. A statement on this certificate does not confer rights to thecertificateholderInlieuofsuchendorsement(s). PRODUCER COMACT Tiffanie EllisHeritageInsuranceServicesLLCNAME: PO Box 1508 PH (941) 723 1400 FAX Palmetto. FL34220 Etr1AIL r:u :___. AIc No: (941)723-1440 INSURED 909 Dennis Ave Orlando, FL 32807 D: Accident Insurance Co 0 COVERAGES °""""r' CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATEMAYBEISSUEDORMAYPERTAIN, 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. 1resRLTR I TYPEOFINSUtANCE AUULINSD WVDI POLICYM1h1BEli PO C E P CYEXP A I COMMERCIAL GENERAL LIABILITY f F MLT LIMITSCPP0017507-1 12/16/2015 12/16/2016 I EACH OCCURRENCE I S 1,000,000IILAu,lar.iAGE OCCUR I I R artA_ c 7rrED II,_jj I PRpv1i_ES rEa k urr-nca; I r 100,000 j r.1ED E)cP (.Fry one pKsan) I $ 5,000 GEIJL AGGREGATE LINT APPLIES PEP,. P_CI'-Y P)ECT UDC OTHERO FERSONAL&ADVINJURY 1,000,000 GEr•ERALAGUREGATE Z,000,OOO PRODUCTS - COMPlOP AGG 5 2.000,000 AUTOMOBILE LIABILITY Aif! AUTO ALL OWNED SCHEDULED AUTOS AUTOS MON-OWNED1,1RE0AUTOS AUTOS l/MBRELLA LIAB OCCUR EXCESS LIAB CLAIMS r,tADE Ea attid?n SOGLY INJURY (Per person) BOCALY INJURY (Peracc'den) PROPER 'DAMAGE Peractid-nt EACH OCCURRENCEI g DED I I RETE, OIJ $ AGGREGATE WORKERS C014PENSATION AND E<1PLOYERS' UASILITY A ff FROFRIETCPJP.ARTPIE:<EClrnbc YIN i F~ICERRiEl:1c•U-R ExrLUCE7W Mandatory In M141) V ves. describe under C'8SCRIPTIOII OF OPERATIOIjs blow NIA PER OTH. STATUrE ER E.L. EACH ACCIDErrr S E.L. GSEASE - EA EMPLOYEE CISEASE - POLICY Llr, IT T DESCRIPTION OF OPERATIONS! LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks schedule, may be attached irmore space Is required) CERTIFICATE HOLDER CANCELLATIONG..-- /nn, non .. -..-. City of Sanford 300 North Park Ave. Sanford, FL 32772 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THEEXPIRATIONDATETHEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCEWITHTHEPOLICYPROVISIONS. AUTHORIZED REPRESENTATIVE F j ACORD 25 2014101 ©1888-2014 A( The ACORD name and logo are registered marks of ACORD FOR All rights reserved. T I I I I 11 I is RICK SCOTT, GOVERNOR KEN LAWSON, SEGRE:IAKY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CMC1249761 The MECHANICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 0 MILLS, JOHN F PAT LYNCH CONSTRUCTION LLC 919 N SHINEAVENUE • ORLANDO FL 32803 RICK'SCOTT, GOVERNOR ' ^ v KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING ROARn I'CICETISE NUtVIBERs. 1 IIG rLUIVID1114U LPUIV 1 M/-\U I UM Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 MILLS, JOHN F PAT LYNCH CONSTRUCTION LLC 919 N SHINE AVENUE ORLANDO FL 32803 a 1.CCImn• nr,/nR/7Md fIICPI av OQ Ri=ru iiPi 1 Rv I MA/ QMn-4 1 1Ananonnn4970 RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1ICEN$E'NUNIBER' The SOLAR CONTRACTOR I Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 MILLS, JOHN F PAT LYNCH CONSTRUCTION LLC 909 DENNIS AVENUE - ORLANDO FL 32807 LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: Dh-0A I hereby name and appoint: an agent of )gr4j1/ 4 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): The specific permit and application for work located at: Street Address) / Expiration Date for This Limited Power of Attorney: .3! (v License Holder Name: z/ z/1 ifl s State License Number: cA& Signature of License Holder: 6 STATE OF FLORIDA COUNTY OF - The foregoing instrument was acknowledged before me this 20t, by ' Se6»y0A C- to me or who has produced identification and who did (did not) take an oath. ZO day of , who is personally known Signature '— Notary Seal) N: 4oc tCk. '5 (- Print or type name Notary Public - State of W42E" Commission No. O My Commission Expires: Rev. 08.12)