HomeMy WebLinkAbout103 Bristol CirCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: c`T
Documented Construction Value: $' Wdb, _
Job Address: Q a 1i R I S T,A G f(I Y,4 i_-1; ,?,4721 Historic District: Yes No Parcel
ID: p7 - O 31 • Ufa b ' 0 600 -19Yb Residential N Commercial Type
of Work: New Addition Alteration Repair Demo Change of Use Move Description
of Work: 1('Ot if c:--' fxh)zJ,J- Ale rV_?Zy1 AA I CL6 it o e-ya U usf Plan
Review Contact Person: Title: Phone:
Fax: Email: Property
Owner Information Name
Nlyk'R611 aOf4M6' V-9. Phone: Street: /
ra e4lj- -04 CAI. Resident of property? : Yif City,
State Zip: j2n .Q I , b 77 Contractor
Information Name
A)R Phone: yzrr Street:
1,6X0 PGV/0c6curd 'I'GVE, Fax: tx S City,
State Zip: 816L i drJ Z f 1 , d 7 yf State License No.: 64C d S_1 q Y3 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: 51h Edition (2014) Florida Building Code Revised: June
30, 2015 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.
Signature of er/Agent Date
Print Owncr/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Signature of Contractor/Agent Date
Name
SUJEILY SANTIAGO•AGAN
Notary Public . State of Florida
Commission # FF 950675
My Comm. Expires Nov 3, 2019
Contractor/Agent is" - -Teirso-nallyAilown to Me or
Produced ID-1_ Type of ID - 1
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing[] Gas Roof
Construction Type; Occupancy Use:
Total Sq Ft of Bldg: 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:
Revised: June 30, 2015 Permit Application
Al I INC. 1650 Providence Blvd.
CO ENTIAL Deltona, Florida 32725
AIR IO ATINq (386) 532-8885
Fax (386) 532-8839 RETAIL SALES AGREEMENT
aircurrentinc@yahoo.com License # CAC057445
www.aircurrentine.com
PREPARED r92 "' FOR: \ DATE: -' EJ
BILLING BILLING
ADDRESS: (Z 1 ADDRESS:
CITY: STATE: ZIP
1fJPHONE:
CITY: STATE: ZIP:
PHONE:
TOTAL COMFORT SYSTEM BEST BETTER GOOD
EQUIPMENT MANUFACTURER
HEAT PUMP / STRAIGHT COOL
OUTDOOR UNIT MODEL #
INDOOR UNIT MODEL# I -r b 1 At JA
HEAT STRIP MODEL! K.W. 4 J 7a C OS-
S.E.E.R. I H.S.P.F. RATING f S iE 2
INSTALLED EQUIPMENT PRICE 7 S-A I i S-
DUCT SANITIZING
5' MEDIA CLEAN EFFECTS OTHER
ULTRAVIOLET LIGHT rJ no , ew S
SUBTOTAL e
LESS POWER REBATE (IF APPLICABLE) f.
EQUIPMENT REBATE (IF APPLICABLE)
TOTAL INVESTMENT
MONTHLY INVESTMENT
AIR DELIVERY SUPPLY # OF RETURN _ FLOOR CEILING SIDE WALL
SYSTEM ECONNECT SUPPLY RECONNECT RETURN NEW SUPP NEW RETURNW
PIPING EW LINE SET USE EXISTING LINES 314- P DRAIN LINE
RAIN PAN W/FLOAT SWITCH LINE COVER CONDENSATE PUMP SAFETY FLOAT SWITCH
ELECTRICAL VJNEW COPPER WIRING TO AIR HANDLER NEW COPPER WIRING TO CONDENSING UNIT
INCLUDES REQUIRED DISCONNECTS, SWITCHES, BREAKERS AND CONDUIT
THERMOSTAT TOUCHSCREEN COMM. w/HUMIDITY CONTROL PROGRAMMABLE TANDARD DIGITAL PROGRAMMABLE
TOUCHSCREEN w1HUMIDITY S2EROL PROGRAMMABLE STANDARD DIGITAL
MISCELLANEOUS LATFORM TOP INSULATE PLATFORM BOX PRE -CAST SLAB R QG
REMOVAL RE OVE CONDENSING NIT REMOVE AIR HANDLE REMOVE PACKAGE UNIT HAUL AWAY
WARRANTY
YR. LABOR R. PARTS WARRANTY YR. COMPRESSOR WARRANTY
0—YR. PARTS & 0—YR. LABOR EXTENDED WARRANTY
TERMS OF CONTRACT
1. All work is to be done between the hours of 8:00 a.m. and 4:30 p.m., Monday through Friday except holidays.
2. Refrigerant recovered according to EPA requirements.
3. The named, and accepting of this contract will allow Air Current Inc. sufficient time to schedule the work to be done.
4. Payment is to be made to Air Current Inc. upon completion of the job according to the terms of the agreement listed above.
5. The named, and the accepting parties of this contract will be held liable for all late charges, collection costs and attorney's fees incurred in collection of payments for this contract.
6. Ownership not conveyed to customers until full payment is received by Air Current Inc.
7. Air Current Inc. is not responsible for problems due to accumulation of dust, soot or scale in existing duct work, corrections of temperature difference or imbalance due to the design of existing
duct system is not included unless otherwise stated above. Increase in air noise due to the installation of new equipment is not warrantied.
8. An Extended Warranty or Extended Service Contract Agreement, if purchased, covers only the equipment provided by the manufacturer. Routine maintenance is NOT covered, but it is
required. Certain other exclusions and limitations apply, as described In the terms of the specific agreement.
We, Air Current Inc., propose to furnish air conditioning products and labor as stated above in accordance with the conditions and specifications set forth in this proposal,
for the sum of: ($ ). Payment is to be made in full upon completion of work. Cash, checks
and major credit cards accepted. Financing may be available and requires prior approval before commencing the work.
All material is guaranteed to be as specified. All work to be completed in a
workmanlike manner according to standard practices. Any alteration or deviation Authorized
from above specifications Involving extra costs will be executed only upon written Signature
orders, and will become an extra charge over and above the original proposal.
Ali agreements contingent upon strikes, accidents or delays beyond our control.
Owner to carry fire, tornado and other necessary Insurance. Our workers are fully This proposal may be withdrawn by us d not accepted within 30 days.
covered by Workmen's Compensation Insurance.
Acceptance of Contract: The above prices, specifications and conditions Buyer's
serearesatisfactoryandareherebyaccepted. You are authorized to do the work as
specified. Payment will be made as outlined above.
Date of Acceptance:
Certificate of Product Retinas
AHRI Certified Reference Number: 7489178 Date: 1/3/2017
Product: Split System: Heat Pump with Remote Outdoor Unit -Air -Source
Outdoor Unit Model Number: RP1436AJ1
Indoor Unit Model Number: RH1T3617STAN
Manufacturer: RHEEM SALES COMPANY, INC.
Trade/Brand name: RHEEM; RUUD
Series name:
Manufacturer responsible for the rating of this system combination Is RHEEM SALES COMPANY, INC.
Rated as follows In accordance with AHRI Standard 2101240-2008 for Unitary Air -Conditioning and Air -Source
Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third
party testing:
Cooling Capacity (Btuh): 35200
EER Rating (Cooling): 11.50
SEER Rating (Cooling): 14.00
Heating Capacity(Btuh) @ 47 F: 34800
Region 1V HSPF Rating (Heating): 9.00
Heating Capacity(Btuh) @ 17 F: 23200
Ratings folowed by an asterisk (') indicate a voluntary ramte 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 sssumes no responsibility for,
the product(s) listed on this Certificate. AHRI expressly discialms all Iablllly for damages of any kind arising out of the use or performance of the product(s), or the
unauthorized alteration of date listed on this Certificate. Certified mtings are valid ordy for models and catflgumtlons listed In the
directory at www.ahridirectory.org.
TERMS AND CONDITIONS
This Certificate and Its contents are proprietary products of AHRI. This Certificate shall only be used for Individual, peraenal and
eonffdentlal referenee purposes. The contents of tMs Certificate may not. In whole or In part, be reproduced; copied; dissemineted;
entered Into a computer database; or otherwise utilized, In any form Dr manner or by any means, except for the user's Individual, }
personal and confidential reference. AIR-CONDITIONING, HEATING.
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
The Information forthe model cited on this coMeate can be verified at www.ahridlrectory.org, click on 'Verify Certificate* Ink we make life better - and enter the AHRI Certified Reference Number and the date on which the certificate was Issued,
which is gated above, and the Certificate No., which Is Usted at bottom dot i ----
201 4Air-Conditioning, Heating,! Refrigeration Institute !
31279501741219854CERTIFICATENO.: