HomeMy WebLinkAbout1320 W 8 St (3)CITY OF SANFORD
DEC 1`7 2012 LDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: 1 a
Documented Construction Value: $ dU- d D
Job Address: 13I � W T1,'
L 3 1-77 I Historic District: Yes No ❑
Parcel ID•
Zoning:
Description of Work: 1- lec:
c o G ,Hera tttlr,
Plan Review Contact Person:
Title:
Phone:
Fax: E-mail:
Property Owner Information
Name '[!�>— Obc, \a o.. Phone:
Street:
Resident of property?
City, State Zip:
Contractor Information
Name'--C:> <S�
Phone: 1,�:;z) `l`h S t-} 3 3 3
Street: ;-� %o o - S • c)c 5� r,
�_ e_ 1�kasFax: j:1
City, State Zip: 0 vA a ., do
r= L 3 '2_�b o s State License No.: L R\ 3 0 N Lk 4 2,=-
0Architect/Engineer
Arch itect/Eng i neerInformation
Name:
Phone:
Street:
Fax:
City; St, Zip:
E-mail:
Bonding Company:
Mortgage Lender:
Address:
Address:
PERMIT INFORMATION
Building Permit O
Square Footage:
Construction Type: No. of Stories:
No. of Dwelling Units:
Flood Zone:
Electrical 0
Plumbing O
New Service — No. of AMPS: New Construction - No. of Fixtures:
Mechanical O (Duct layout required for new systems) Fire Sprinkler/Alarm 0 No. of heads:
Application is hereby made to obtain a pen -nit
work or installation has commenced prior to t
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, tauks, and
air conditioners, etc.
to do the work and installations as indicated. 1 certify that no
to issuance of a permit and that all work will be performed to
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 pen -nits 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.
c
� ,�,�r ' I Z • 7 . i '2.
Signature of Owner/Agent Date Signature of Contractor/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:
Rev 11.08
Ptractor/Agent's Na
ria
Signature of Notary -State of Florida Date
PIT
•......
•.•��tPlRfs ••.. 6
�cro,7A14 : phi
cS1 ! li
Contractor/Agent is
Produced 1D
UTILITIES: WASTE
BUILDING:
or
-%posal / Contract
QUANTUM tom' ELECTRIC
Licensc 4: ER 13014400
2800 S. Orange Blossom Trail
Orlando FI. 32805
P. (407) 4854333 F. (866) 658 1364
damian@quantumelectricfl.com.
NAME: Mr. lames Cooper ADDRESS: 6022 Ambassador Dr OWNER NAME:
PHONE: 407 227 0419 CITY/ZIP: Orlando FI DATE: 12/17/12
PROJECT DESCRIPTION: Electrical wiring for room alteration as outlined on the drawing provided for
quotation December 10, 2012.
TOTAL INVESTMENT: $6,100.00 DEPOSIT: $2,440.00 BALANC DUE IN PROGRESS: $ 3660.00
SCOPE OF R'ORK: A k show►, o►vthPi rued. drawing date& (1/12/12). 711& auraUcl t't ovv o f ce !*tgfa#w
avtd� extx rior ftxti� rem sha lL ire as -pa rt o f tat iso scopes Any d irrupt C&w o f dtz elects+ cat,L
system from. Xkorq"utl, stagthat shall be, restornds shall be, price& onv a.tf~ a vt& maft real,
basis- a i& mu st bei aoree& u pon. iw writ vtg, be fore- avt y work, t& donees Pwyme rt t term& {or an y
suchv chaeuoe k are• ft+v (10) days- of completwvu 7'h& el ec&Zcctb service- 4, va"& and, a& s4z1v ck
not a, part of th4sr quoit, It must be, f F,eU vl ri f%e& a*u � priced accordio y.
WARRANT,: All, materiaba#t&labor i*warra.ntt, Lfvr a.perioti.of ovv&yearf vmc rmp etfonu AiLlabar
%nuvbved.in.any repair notre2ated�to-infrrior insta&Luo vor poor work"utvt.shq) wi2Lbe, bLUed to -owner.
Owner/Cuslomer acknowledges that he/she has read and received a complete legible copy of this agreement and hereby authorizes the contractor to proceed
with the work In accordance with the terms herein. This agreement is subject to all provisions In the General Conditions on the reverse side hereof, which are
by reference as if fully written herein. Owner / Customer has reviewed and understand the General Condition and has been prodded a copy of the General
Conditions affecting the work for this project, including the granting of a limited warranty by Quantum Electric LLC. The Owner shall be protected by all
warranties running directly to him/her Prom material supplier and subcontractors. The above price is based upon the stated dimension and current costs and
does not include the cost of additional labor or materials unless otherwise stated, for cutting ,patching of concrete or drywall , or other services for attachment
of the improvements or change In design or structure to rectify conditions encountered in the field upon installation.
Contractor reserve the right to revise the above price based upon the estimator's inspection of the job site and/ or increase in costs of material and labor. If
the installation is not commenced within 30 days of the dale of this agreement Purchaser shall pay the revised purchase price which shall not exceed 25% of
the proposed. Labor and /or material warranties are non -transferable unless extended by Quantum Electric LLC. The prices, specification and condition
contained above and in the General Conditions are accepted. Payment will be made as outlined above or an agreed progress payment. I agree that the
contractor shall take any action to enforce Ibis contract, including stop working after Five (5) days of nonpayment notification. I (the under signer) shall pay
contractor's costs Incurred, including attorneys fee, and legal expenses, expert witness fees and interest, whether or not a lawsuit Is filed. Venue of any lawsuit
pertaining to this contract shall be in Orange County Florida.
-7/Ae e r �"� P�� Date: f L - (7-(?-
Approved
7 (2Approved By Customer (Print) Approved By Quantu%Ellectric LLC.
Cancellation Notice
You may cancel this transaction within three (3) business daffy from the date originally signed. To cancel this transaction, mail a copy of this cancellation notice or any other written notice to:
Quantum Electric LLC 2800 S. Orange Blossom Trail Orlando F132805.
Customer Signature �G- -+-�� "'y�i'« Date
This 4ont act nepresents the entire agreement between buyer and seller and is binding when accepted by the officer of Quantum Electric I.I.C.
Quantum Electric is not responsible for what is not written on this contract.
GENERAL CONDJTION
DEFINITIONS -(a) In the event that drawings and specifications have been furnished in connection with the work covered by the contract, the same shall constitute a part of this contract and are
incorporated herein by reference. (b) In the event that the Owner/Customer is represented by an architect, engineer, contractor, or supervisory employee, the decisions of such individuals shall
include any such representatives where the context permits. where this contract is entered into by Quantum Electric LLC and a General Contractor tiered subcontractor, references to "Owner'
shall extend to said party. (c) As used herein the word 'Contractor' refers to Quantum Electric LLC., unless the contract clearly indicates otherwise. Initial
ACCEPTANCE- In the event that the Owner/ Owner Representative accept a contract based upon this proposal, the terms and conditions herein shall be deemed to be incorporated in the said
contract. The terms and conditions set forth in this proposal govern in the event of conflict with any terms or condi tions soof• Owner's proposal are not subject to change by reason of any written or
verbal statement of Owner or by any terms stated in Owners contract, unless accepted in writing by Contractor. lnitral L
TIME FOR COMPLETION -Contractor agrees that said work shall be prosecuted regularly, diligently and uninterruptedly at such a rate of progress as will insure full completion within the time
specified. It is expressly understood and agreed, however, that the time for completion set forth on the reverse side hereof is calculated as a reasonable time for the completion of the work,
taking into consideration the average climatic range and usual industry condition prevailing in the locality. Contractor shall not be liable for failure to complete the contract within the time
specified if such failure is due to strike, differences within workmen, delay or failure to secure material from source of supply, or any circumstances beyond the control of contractor not herein
enumerated. Contractor reserve the right to stop work any time payment is past due and owner expressly agrees to said suspension in work and that said suspension shall not be considered
breach of this agreement. Initial L
CHANGES IN WORK- The owner may from time to time make changes in the work to be performed by contractor hereunder, issue additional instructions or require work. if such changes, not
covered by an extra work change, cause an increase in the amount of work hereunder or in the cost of performance, contractor shall be paid on a time and material basis at $a� per hour
whether or not the same were performed by virtue of verbal or written instruction. Payment for extras shall be due in full 10 days after owner is invoiced by contractor for the amount of extras
then completed. If such changes shall increase the time required for performance, the time for completion of the contract as stated on the reverse side hereof, shall be increase by the amount of
time reasonable necessary for the performance of such changes. Contractor shall not be responsible for failure to make changes as directed by owner unless the request is in writing and such
extras are accepted in writing by Contractor Initial_YL
CHANGED CONDITIONS- In the event: (a) Hidden or latent physical conditions at the site differing materially from those mentioned in this contract or Owner (b)of unknown physical or
underground conditions at the site of an unusual nature, such as old or unstable foundation, structure support or any other unknown condition that impedes performance or gives rise to
additional costs or (c) that abnormal weather conditions are encountered during construction, and if any such condition cause an increase in the contractor cost of, or the time required for
performance of this contract, and equitable adjustment shall be made on a time and material basis and the Contract modified accordingly. PAYMENT -Unless otherwise specified on the front side
hereof, the Owner shall make payment to the contractor within 10 days of receipt of an invoice for work performed to the time stated on the invoice based upon the contract price, for labor and
material incorporated in the work and of material suitable at the site thereof as estimated by contractor, less the aggregate previous payments. Final payment shall be due upon substantial
completion of the work, unless a specifically identified date is provided on the reverse hereof. The date of substantial completion of the work or any designated portion thereof is the date when
the work is complete in accordance with this contract. initial Z e
RISK OF LOSS -TITLE- Risk of loss of material incorporated in the work and materials suitable stored at the site thereof shall be upon the owner. Title to material incorporated in the work or stored
at the site, however shall remain the contractor's until it has received full payment under this contract, and in this connection all material incorporated in the work shall remain the personal
property until final payment. In the event the owner is not the owner of the real estate upon which the project is to be constructed, the Owner agrees that the landowner consent has been
secured that the aforesaid material shall remain personal property, until payment in full has been made. Initial -'> e•
SURVEYS, DRAWING, PERMITING AND REGULATIONS- The owner shall furnish all surveys and drawing unless otherwise provided here, showing residence plans, all easement and setback location
and zoning restrictions. Permits and licenses of a temporary nature necessary to the prosecution of the work shall be secured by contractor and paid for by the Owner. Permits, tap fees,
assessment, licenses and easement for permanent structure or permanent changes in existing facilities shall be secured and paid for by the Owner. Contractor shall give all notices and comply
with all laws, ordinances, rule and regulations bearing on the conduct of the work as drawn and specified. Initial
DISCLAIMER OF WARRANTIES—EXCEPT AS EXPRESSLY PROVIDED, CONTRACTOR MAKE NO EXPRESS OR INPUED WARRANTIES AS TO ANY PORTION OF THE PROJECT OR MATERIAL INCORPERATED
THEREIN, AND NO RESPONSIBILITY OR ORLA AFFIRMATION OF CONTRACTOR SHALL CONSTITUTE A WARRANTY, CONTRACTOR EXPRESSLY EXCLUDE ANY WARRANTIES OF FITNESS FOR
PARTICULAR PURPOSE AND MERCHANTABILITY FROM ITS PROPOSAL AND THESE TERMS AND CONDITIONS. Contractor liability for negligent or improper workmanship shall be to repair thee work
only. Owner expressly waives any indirect or consequential da:m!jae arising from contractor's workmanship. Contractor shall not be liable to owner or any employees, invitees or other persons on
the job site at the owners express or implied invitation. Initial > •G
LIMITED WARRANTY- The Contractor here warranty's that the workmanship utilized on the job are guaranteed for a period of (1) year from the date that said installation was completed. The
contractor shall not be liable for any damage or loss either during installation or during (1) year under which this guarantees is applicable is said loss resulted from vandalism, acts of God, or
negligence on the part of the Owner. All material will carry the manufacturees full factory warranty. See individual manufacturer card for complete information. Initial
WAIVER- A claims of Owner for improper workmanship or damages by contractor acting during the course of said work on the project shall be provided to contractor in writing within (5) of the
date owner had or should have had knowledge of said claim. Written notice shall be provided only by U.S certified mail, return receipt requested. Failure to timely provide written notice of said
claim shall constitute a full and complete waiver of said claim. Upon timely receipt of any such notice by contractor, Contractor shall be provide reasonable time to cure any improper work, but
shall in no case shall Contractor be provided less than (5) days to cure any claims of improper work. Initial j (✓
SUBCONTRACTING -Contractor may utilize the services of subcontractors or independent contractors on any part of the work involved in the contract. Nothing contained herein shall create any
contractual relationship between the subcontractor and the Owner. Initial .1 "L.
FAILURE TO MAKE TIMELY PAYMENT -In the event that Owner shall fail to pay any amount due to Contractor hereunder, when the same shall be due, such amount shall bear interest at the rate of
10% per month until the same is paid. In the event the owner shall default in making timely payment for 48 hours after receipt of written notice from contractor of such default payment, time
being of the essence, Contractor may immediately, suspend work, terminate this contract and /or bring suit against Owner for its damages, including lost profits or proceed with any other or
further remedies provided by law or in equity. Owner shall be responsibility for all con of collection, including attorney's fee incurred by Contractor, whether or not court action is necessary. No
warranties shall be extended by Contractor until final payment is made. Initial � C—
SOLE AGREEM ENT -This agreement constitute the sole and entire agreement of the parties with respect to the transactions contemplated.
PARAGRAHP TITLES- The paragraph titles are inserted hereon only for reference and are in no way to be construed as a part of this agreement or as a limitation of the scope of the particular
paragraph to which they refer.
APPLICABLE LAW- This agreement shall be interpreted according to the laws of the State of Florida. Venue is expressly agreed to be in the State of Florida, County of Orange. EXCLUSIVE
AGREEMENT- The terms and conditions contained herein and the proposal incorporating these provisions are intended as a final expression and complete and exclusive statement of the terms
and conditions of the agreement between Owner / Owner Representative and Contractor (Quantum Electric LLC). This agreement may not be modified except in writing signed by the Contractor.
RU
® RLI
O. Bo 3967 Peoria
I POWER OF ATTORNEY
P.O. Box 3967 Peoria IL 61612-3967
Phone: (309)692-1000 Fax: (309)683-1610 RLI Insurance Company
Bond No. LSM0228377
Know A11 Men by These Presents:
That the RLI Insurance Company , a corporation organized and existing under the laws of the State of
Illinois , and authorized and licensed to do business in all states and the District of Columbia does hereby make,
constitute and appoint: HaySant Georgi in the City of Altamonte Springs , State of
Florida , as Attorney In Fact , with full power and authority hereby conferred upon hirn/her to sign,
execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds, undertakings, and recognizances in an
amount not to exceed Two Hundred Fifty Thousand and 00/100 Dollars ( S 250.000.00 ) for any single
obligation, and specifically for the following described bond.
Principal: QUANTUNLELECTRIC,.LLC._
Obligee: City of Sanford.Ruilding Diyision_
Type Bond: ELECTRICAL CONTRACTOR
Bond Amount: $ 2,000.00
Effective Date: December 17, 2012
The RLI Insurance Company further certifies that the following is a true and exact copy of a
Resolution adopted by the Board of Directors of_ RLI Insurance Company , and now in force to -wit:
All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the
corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or
1 by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant
Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or
undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies,
undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the
corporate seal may be printed by facsimile."
fN WITNESS WHEREOF, the RIA Insurance Company has caused these presents to be executed by
its Vice President with its corporate seal affixed this 17th day of December 2012
ATTEST: ,.`�5`?� �OAy.RLI Insurance Company
ORP
.SEAL.
Cynthia S. hrn Assistant Secretary ''••....••S• Roy C. Di '
Vice President
On this 17th day of December 2012 before me, a Notary Public, persona geared Roy C. Die
and Cynthia S. Dohm , who being by me duly sworn, acknowledged that they signed the above Power of Attorney
as Vice President and Assistant Secretary , respectively, of the said
RLI Insurance Company , and acknowledged said instrument to be the voluntary act and deed of
said corporation.
-
�� M07u+r
"OFFICIAL SEAL-
ALRC 1ACOUELINE M. BOCKIER
Jac eline M. Bock r Notary Public u'�'g
COMMISSION EXPIRES Oa/t9/1�METZ
A0006104
RLI
nce
RLI
® P.O. x3967 Peoria
POWER OF ATTORNEY
P.O. Box 3967 Peoria IL 61612-3967
Phone: (309)692-1000 Fax: (309)683-1610 RLI Insurance Company
Bond No. LSM0228377
Know All Men by These Presents:
That the RLI Insurance Company , a corporation organized and existing under the laws of the State of
Illinois , and authorized and licensed to do business in all states and the District of Columbia does hereby make,
constitute and appoint: HaySam Georgi in the City of Altamonte Smogs , State of
Florida , as Attorney In Fact , with full power and authority hereby conferred upon him/her to sign,
execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds, undertakings, and recognizances in an
atnount not to exceed Two Hundred Fifty Thousand and 00/100 Dollars ( $ 250.000.00 ) for any single
obligation, and specifically for the following described bond.
Principal: QUANIMLELE.CTRLC,.LLC.__
Obligee: City_of Sanford_Building_Divigion
Type Bond: ELECTRICAL C_NO TRACTOR
Bond Amount: _$__2,000.00
Effective Date: _December 17, 2012
The RLI Insurance Company further certifies that the following is a true and exact copy of a
Resolution adopted by the Board of Directors of RLI Insurance Company , and now in force to -wit:
"All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the '
corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or
by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant '
Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or
undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies,
undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the
corporate seal may be printed by facsimile."
IN WITNESS WHEREOF, the 111,1 Insurance Company has caused these presents to be executed by
its Vice President with its corporate seal affixed this 17th day of December , 2012
ATTEST:
°... ...... q,RLI Insurance Company
t1 _ —
.SEAL.
Cynthia S. hm Assistant Secretary Roy C.Di Vice President
On this 17th day of December , 2012 before me, a Notary Public, persona geared Roy C. Die
and Cynthia S. Dohm , who being by me duly swom, acknowledged that they signed the above Power of Attorney
as Vice President and Assistant Secretary , respectively, of the said
RLI Insurance Comuanv , and acknowledged said instrument to be the voluntary act and deed of
said corporation.
Z[DDEK
�'� "OFFICNoupr.us�w �ACOUELI,Jac cline M. Bock r Notary Public IUMOS COMMISSION
A0006104