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Home My WebLink About1750 Retreat View CirCITY OF SANFORD NOV 16 2016 BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: ZER0 Documented Construction Value: $ 6 Job Address: RfkreJ\A, Vff W Qr& 'P4&4& 32 31 Historic District: Yes ❑ No k Parcel ID: Residential,l Commercial ❑ Type of Work: New ❑ Addition ❑ Alteration ❑ RepairN Demo ❑ Change of Use ❑ Move ❑ Description of Work: (,Prn,01P.1� A A, S\Ask— Cl/Vi 4g _ aa 1; k._ -Csr L%to- Plan Review Contact Person: _ SLOW Mi 55v Title: —ts'� Phone: ��'-Z,Z.�'bR7U�-- Fax: Email: ViUD-6 ck5HS0LYj i;k--N Property Owner Information Name _� F:►a. CEP r Phone: Street: Ke,lfeF-+ Vr�_w cwii, Resident of property? City, State Zip:iwrl Contractor Information Name ,p+i� �ti?.o� , ? Xr Ci9 %t�1�6nct� Phone:�- Street:1W\A L=Qu wo �a LOALe. /Y)w ,,12rl *)opo Fax: a City, State Zip: L",-z ock . ft 32�D State License No.: C r, j al 61 Lf Arch itectlEngineer 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: 5" 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 icontract 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 infor tin is accute and that all work will be done in compliance with all applicable laws regulating constr ctio and zo ng. Signature of Owner/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 i k to Date �5a�. rnu«t Print Contractor/Agent's Name +'LQA Signature of Notary -State of Florida Date VICTORIA LYNN FUENZALIDA •': MY COMMISSION 0 FF205268 EXPIRES Mach 03.2019 Contractor/Agent is ear Produced ID ype of ID BELOW IS FOR OFFICE USE ONLY Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing❑ Gas[] Roof ❑ Construction Type: Total Sq Ft of Bldg: Occupancy Use: Flood Zone: Min. Occupancy Load: # of Stories: New Construction: Electric - # of Amps Plumbing- # of Fixtures Fire Sprinkler Permit: Yes ❑ No ❑ APPROVALS: ZONING: ENGINEERING: COMMENTS: # of Heads Fire Alarm Permit: Yes ❑ No ❑ UTILITIES: WASTE WATER: FIRE: BUILDING: Revised: June 30, 2015 Permit Application HEATING &AIR CONDMONING 407.2218007 ScottsAir com Licensed d Insured =_ _ CAC1816941 when Iris 1w, Call Soofd Invoice S80 f won Euaralreftdl CLIENT NAME: (I i/\ VW r• ADDRESS: I } 3 F ��' ; t' �' /1 y i_ 'uJ a a L.� ^ d., �CC CITY, STATE, ZIP: PHONE: • EMAIL: MODEL # MODEL # SERIAL # SERIAL # MODEL # SERIAL # MODEL # SERIAL # SE -R" 1 E-PEERRPORMEDy �l ('x'12.: ' i ' R ,� �. l ! : ► 1 : t_ / • t� ?y.rv� r PARTS AND MATERIAL NEEDED FOR REPAIRS: TYPE OF PAYMENT [:]CASH ❑ CHECK []VISA ❑MASTERCARD []AMEX [:]DISCOVER CHECK# DL# 01.487 DATE: TIME IN: TIME OUT: TECH: _ START UP DATE: FILTER SIZE: SERVICE PROBLEM: INSIDE: AMPS EVAP COIL HEAT FAN CLEANED MOTOR TEMP SPLIT IN OUT DRAIN LINE: PAN CLEANED Y / N DRAIN LINE CLEANED Y/N The undersigned has authority to order the above labor and materials on behalf of the above named purchaser. The labor and materials described above have been completely and satisfactorily performed and furnished. The above described materials shell remain property and the Idle to same shall be retained by Scott'} Heating 8 Air Conditioning until payment is made by purchaser in full Scott's Heating 6 Air Conditioning DIAGNOSTIC FEE: is not liable for any defects in labor or materiels unless the purchaser gives written notice of such defects within ten days from the date of this contract Payment in full is due upon receipt of this invoice and payable upon completion of work Purchaser agrees to pay all costs of collection mcludohg a reasonable attorney's fee, in the event this contract is not paid in full when due and some is placed in the herbs of an attorney for TOTAL TASK AMT: collection, foreclosure, or repossession, whether suit be brought or not All delinquent payments shall bear a service charge of 1.5% per month until paid. Purchaser waives demand and all requirements necessary to hold it liable. Purchaser agrees that the said materials above described will not be moved from the above address without the prior written consent of Scotts Heating & Conditioning. Selling price of all parts and equipment are.on an exchange basis with purchaser's old parts and equipment. Warranty on all parts per manufacturer's warranty policies 90 OTHER: Day Labor Guarantee. only on that portion previously serviced P my payment is by Greek and my check is returned for any reason. I authorize the merchant to electronically debit my accourp for the amount this item plus any fees allowed by law. .� 'C, Gam. Total Due: X ,r P.O. Box 521796 Longwood, FL 32752 • Info@ScottsAir.com OUTSIDE: AMPS LOW PRES COMP. FAN HIGH PRES MOTOR SUPERHEAT SUBCOOLING COIL CLEANED TEMP SPLIT IN OUT INSIDE: AMPS EVAP COIL HEAT FAN CLEANED MOTOR TEMP SPLIT IN OUT DRAIN LINE: PAN CLEANED Y / N DRAIN LINE CLEANED Y/N The undersigned has authority to order the above labor and materials on behalf of the above named purchaser. The labor and materials described above have been completely and satisfactorily performed and furnished. The above described materials shell remain property and the Idle to same shall be retained by Scott'} Heating 8 Air Conditioning until payment is made by purchaser in full Scott's Heating 6 Air Conditioning DIAGNOSTIC FEE: is not liable for any defects in labor or materiels unless the purchaser gives written notice of such defects within ten days from the date of this contract Payment in full is due upon receipt of this invoice and payable upon completion of work Purchaser agrees to pay all costs of collection mcludohg a reasonable attorney's fee, in the event this contract is not paid in full when due and some is placed in the herbs of an attorney for TOTAL TASK AMT: collection, foreclosure, or repossession, whether suit be brought or not All delinquent payments shall bear a service charge of 1.5% per month until paid. Purchaser waives demand and all requirements necessary to hold it liable. Purchaser agrees that the said materials above described will not be moved from the above address without the prior written consent of Scotts Heating & Conditioning. Selling price of all parts and equipment are.on an exchange basis with purchaser's old parts and equipment. Warranty on all parts per manufacturer's warranty policies 90 OTHER: Day Labor Guarantee. only on that portion previously serviced P my payment is by Greek and my check is returned for any reason. I authorize the merchant to electronically debit my accourp for the amount this item plus any fees allowed by law. .� 'C, Gam. Total Due: X ,r P.O. Box 521796 Longwood, FL 32752 • Info@ScottsAir.com LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date: (D 11511 \D I hereby name and appoint: ,b(V1 VV0.�`C,Pf an agent of: (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): O The specific permit and application for work located at: (Street Address) Expiration Date for This Limited Power of Attorney: (01 1S/ I --t License Holder Name: St-o�k fY\p )r - State License Numbe Signature of License STATE OF FLORID. COUNTY OF $ The foregoing instrument was acknowledged before me this Aay of �Nv e. , 200 Imo( , by _5 W}V /Y\oN-5�- who is mrpersonally known to me or o who has produced identification and who did (did not) take an oath. Signature .✓' y VICTORIA LYNN FUENZALIOA •: ION p FF205268 *'.I•;�.f.'h: E�Sarcfi 03.2019 iFrLbNnu Senr�rwr (Rev. 08.12) Vi c� D I- Print or type name Notary Public - State of EO 64. Commission No. My Commission Expires: YY%ar,A , 3..Z0\q as