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Permit # : 0-7 " ( 4 (A
Job Address: 10P VCY)-krC.
CITY OF SANFORD PERMIT APPLICATION
Date: ) G t 20lcu
3 :2 Z--) 3
Description of Work: C hC r�; e Q(. /_ 3 4-ein 4-110
CCnc'1 Pn s ,-,-- �- A J N _tUC b o oL6 JC`l-(�_
Historic District: Zoning: Value of Work: S- -j i O
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Permit Type: Building Electrical Mechanical `� Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration
.,"� Change of Service Temporary Pole
Mechanical: Residential wZ Non -Residential Replacement
New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets
Plumbing Repair — Residential or Commercial
Occupancy Type: Residential Commercial Industrial
Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units:
Flood Zone: (FEMA form required for other than X)
Parcel #: /G -96-30 - 5-GC/�n/Cf C G Cc 3G
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Owners Name& Address: kl5h G-9SGI/,, /�e-ti Pe V.
(Attach Proof of Ownership & Legal Description)
/cWr UC1n*tJr4 71y,
Contractor Name & Ads
s: e t7J1
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Phone & Fax: qG� •� C�Cl. iPC�
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
I l (Y -,C, 4- •t?
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Person:
Phone: -� ! C,%' C L( F� -G �Zo
C!`q"o G� /✓GGci /�9G-2
tate License Number: C4C G79 ?& b 9'
G� Phone: ` c,) -COLI LI J LpCf
Phone:
Fax:
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. 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 require is of Florida Lien Law, FS 713.
Signature of Owner/Agent Date Signature of Contractor/Agent Date
Print Owner/Agent's Name Print Contractor/Agent's Name
Signature of Notary -State of
Owner/Agent is _ Personally Known to Me or
_ Produced ID
APPLICATION APPROVED BY: Bldg:
(Initial & Date)
Special Conditions:
Date /Signature of Notary -State of Florida
Contractor/Agent is _A_ Personally
_ Produced ID
1O 70,CONNOR..........�
1 P& Comma OD0424343
Expires 611/2009
yVn�cca`�'' Bonded thtu (800)432-4254'
:l�;,tvie or Florida Notary Asan., Inc :
....................................:
Zoning: Utilities: FD:
(Initial & Date) (Initial & Date) (Initial & Date)
DS -2,:0U
Crums Climate Control Inc. ....Since 1941
4
Air Conditioning, Heating & Fireplaces
980 Railroad Ave. Winter Park, FL 32789 (407) 644-6601
Proposal Submitted To: r�Date Phone W / H
I C S
Street ( Job Location) City State Zip Code
Street ( Billing Address) City State Zip Code
We hereby propose: To furnish, install and service underwarranty ( stated below ) products and service or related
equipment for your home or business in accordance with the conditions and specifications set forth in this proposal.
0 A/C Condense[
IVP Condenser : k h l y-�y? •K_V
SEER i -� KW PKG SPLIT
Coil
® Air Handler AA'1�
Horz R Horz L Down — Vert
Oil Furnace
Gas Furnace
Other
® Liquid Line ✓ vC? / I r�
Suction Line
Aj Condensate Purainline
Lineset Protective Cover
Zoning _ Zones
Supply Duct
ReturnDuct Direct Ceiling SW
Insulate Platform
New Platform
Air Purifier
Air Filter Type& Size+/����� ����►�
Duct Sanitize U p\\® ` `e
Duct Clean : Accept Decline—
Duct
ecline Duct Seal: Accept Decline
New Service Upgrade
® New FIrlMri" to Condenser I�issew�ec>
New Electrical to A} lU Disconnect
Heat Recovery Unit
NOTES
p
&A/C Pad and Size l jrF w
0 Thermostat : Mercury Digital Programmable
0 Balance Air System
QFirestat
® All work done in accordance with existing codes.
Removal of existing equipment from the premises
All work to be performed in a neat and professional
manner by a trained technician. Sweeping, dusting and
vacuuming will be accomplished at the conclusion of
each day of work and all debris removed from the premises.
® Warranty on Parts -Lc- Years. Condenser & air handler only
Warranty on Labor—LYears. Condenser & air handler only
Warranty on Zoning Electrical
Warranty on Dampers
Warranty on Compressor
Warranty on Duct Work
Warranty on Other
Total Price (tax included) $ J `� 17 co
IVt''Lt{ iY��t%�\y"vilC: i'�'�•iTEfir\ dollars
Terms: /tel n
'All Fmm, ins R &T 70',
Signature (company)
Signature (customer) X t i
�/ /Z,/._ ; '/ Lv X—C—
Date:
- C
Date: G ' (.,'X Proposal valid until:
Options: � JM/CA's /VC E�IY C
Requested Install Date T c
Finance paperwork must be signed before the start of work
BUYERS RIGHT TO CANCEL : You, the buyer, may cancel this transaction without penalty any time prior to midnight of the third business
day after the date ofthis transaction. See reverse side for terms and conditions.
Ifyou sign today to take advantage q a discount, your have two weeks to cancel before installation.
Crums Climate Control, Inc.
Air Conditioning, Heating, & Duct Cleaning
June 13, 2006
To Whom It May Concern:
I he eby name and appoint
(Printed Name of Appointee)
0 rc.►ns 0 It vn of � e Ccr► �- rcl
(Company Name of Appointee)
To be my lawful attorney-in-fact to act for me in applying to City of SCG r 44 0
Government Commercial/Residential Permitting for a permit enabling work to be performed at the
location below -describe and to sign my name and do all things necessary to this appointment.
/U Section
G
Township
30
Range
56S
Subdivision
O€100
Block
O U 3 Lot
/Gk k eh �&,rc� 7)y-'� Project Address
?ctyl CY, 9e( -CL W Owner of Property
�C tl e A -r4 I)✓ Owner Address
Signed:
�r
(Brian Wrong, Certified Contra or)
License No: CAC0042669
Date: //h s �c&
Sworn to an subscribed before.me this K day of A&ffbbev , 20c(, by
1?00h Ghityy who is pers a y known to me o has produced
(identification)
FIONA O'CONNOR
NIIIIII.��
Comm# DD0424343
Expires 5/1/2008 -
®a' Bonded thru (800)4324254:
....0 m�`..... .Florida Notary Assn. Inc -
..... ............ ...........'
980 Railroad Ave.
Winter Park Florida 32789
Notary Public
Phone: 407-644-6601
Fax: 407-645-1698