HomeMy WebLinkAbout2440 W Airport Blvdt /'% CITY OF SANFORD PERMIT APPLICATION
Permit # :
Job Address:
Description e
Historic Disti
Permit Type: Building Electrical Mechanical X Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS Addition/Alteration Change of Service Temporary Pole _
Mechanical: Residential -X— 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 X Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel q: 3J5 - Iq - 30 S1- 000c) - OQ Qo (Attach Proof of Ownership & Legal Description)
Owners Name & Address:R-nt\V -Ri- ifYY\n i CYini-r % 1.1U ("-% A0 N, v-i
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer: Phone:
Address:
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 theissuanceofapermitandthatallworkwillbeperformedtomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. 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 maybe additional restrictions applicable to this property that maybe 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 it is veniicati n that I ' notify the owner of the property of the require is of Florida Lien Law, FS 713.
na re n /Agent DJte Signature of Contractor/Agent Date
7-,Ca 1\L Cs= Sr an Wi On!RPrintOwner/Agent's Name Print Contractor/Agent's Name
kLA6,i
Signatur = f Nota fGr4QNNOR Date Si azure of Nota State of Flo am
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endsd Yw (a00)tS2426a: Owner/A#t:n „ Persp+ yr Vv1 • Contractor/Agent is ><Person I INN W*o Fto ida Notary Assn., lneProduces _ Produced ID i............................................i
APPLICATION APPROVED BY: Bldg: Utilities:
Initial & Date) (Initial & Date) (Initial &
Special Conditions:
J Iks.— 401.64t4. (60 f
4"t . 4o43. l 648F;kX
Zoning:
APR 2 1 2006
AND DEVELOPMENT
Crums Climate Control Inc. ....Since 1941
Air Conditioning, Heating & Fireplaces
980 Railroad Ave. Winter Park, FL 32789 (407) 644-6601
44,
Proposal Submitted To: Date Phone W / H
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 Condenser
H/P Condenser L ^ ^ r
SEER-12— KW PKG SPLIT
0 Coil
Air Handler
Horz R Hon L Down — Vert X
6il Fm,race /r/i .F'/as 6.1/1k/ 0
Gas Furnace / Other -
c . .. rr,„ , •f / r5 r_c fu Liquid
Line Suction
Line 15endeneata-
1?ump / Drainline 0
Lineset Protective Cover 0
Zoning Zones Supply
Duct ' G' ', o'/.
i Au %S i
Retum
Dort /' Direct / Ceiling S Insulate
Platform / ,-e- /' '/ 0
New Platform 0
Air Purifier 0
Air Filter Type & Size 0
Duct Sanitize 0
Duct Clean: Accept / Decline 0
Duct Seal: Accept =/ Decline 0
New Service Upgrade QNew
Electrical to Condenser rV a V Disconnect 0
New Electrical toAHU ADisconnect 0 Heat
Recovery Unit NOTES A2
A/C
Pad and Size , • ? c. Thermostat : Mercury
Digital 1 Programmable 0 Balance
Air System 0 Firestat
All work
done in accordance with existing codes. Removal of
existing equipment from the premises 0 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-? Years. Condenser & air handler only U Warranty
on Labor % Years. Condenser & air handler only 0 Warranty
on Zoning Electrical 0 Warranty
on Dampers Warranty on
Compressor -4 ,, /7 Warranty on
Duct Work 0 Warranty
on Other Total Price (
tax included) $ j rT -- %, q0 h' _I_
n e dollars l
Terms:
AII
F...-`
h Tams uc Padmg Crcd,. qP WW. Signature (company)
Signature (custiimet)
1 - Date: Proposal
valid until: Options: Requested
Install
Date y-..S G • o Finance paperwork
must be signed cite- 2
c: 2006 t
BUYERS
RIGHT
TO CANCEL: You, the buyer, may cancel this transaction without penalty any time prior to day after
the date of this transaction. See reverse side for terms and conditions. lfyou sign
today to rake advantage of a discount, you have two weeks to cancel before installation.
1 K. Wood, Tax CoMetter, a pati l +nse --Orangege County, Florid:
tense is in addition .to•andanot in beu t.gny:others:i er a rs uj cl lw;orr y u l al Ordi[a c* . I,t t$ . ct•to, rggulation.of zoning, health and any other lawt
rity. It is valid from October 1 through September 3bMao v r. 1eil 'gena'Ry'is added'Qcttib
2005*** EMP I g 18;04-067012
ORIGINAL 09 100-0'•6
804 CONTR-.HARV
r'
3, WORKER.
000 BUSINESS OFFICEIQ, ON
0 ' fORKF:R`S
TOTAL .T ^6 . D' _ I j r MST, CONTROL INC
TOTAL tI31
TOTAL DUB . 8` 0 Ft 32790-0250
980 RAILROAD ,AV
B - WNBtRR ' PARR WING BRIAN D .
PAID 6.0..00 919-32.
R /2OCO5
This form becomes a receipt when validated by the Tax Collector.
CITY OF SANFORD
APR p 1 2006 11
PLANNING AND DEVELOPMENT
E15 3• Q, 4 9`: '. t. STA" ' Q FLORIDA
DBP OF - IIS . PROFESSIONAL liTvN3M1 ,7IONNI RY LI'C TSI270 SC
LICZNSN NSR . '';• ,
4I ASS A AIR , C NDITj0*±N0-
Famed :below :36` C iw1s,
hder' l-ihd pri-vl-s oas c f - Chappt'
xpiratioa date: AUG 31, 2006
IRONO HRIAN.DAVID a , RUM'...
CLII4A3'L CQNTROL NC 551
THORNLSA RD` ' CUD w.::., RLANDO .
FL 32817 c> v:W .
DISPLAY
AS REQUIRED BY. LAW L04081003159
gTATE
oF FLoRwA AC# b 5 3 0 7 4 9 DSPAR.,.
OP 8 SINBSS AM PROPBOi".
CLATION CAC042669
s
4:
040124-036 CBRTIPIBD''
W40110,
81 CR`
l S CL a'f j,,NC I8,
CBRTIHISD'uudow the prwielms of ch.489 se. movts.
ttoo Antos AUG 31, 2006 L04081003159 DETACH
HERE m (
40 343-zzZ7 CITY
OF SANfORD APR
1 2006 PLANNING
AND DEVELOPMENT
om: Brenda C:?Idwell At: SellersKuykendall, LLC FaxID: 407-629-6378 To: Previn Deva Date: 2/22/2006 10:14 AM Page: 2 of 2
DATE (MWDD/YYYY)
ACORD_ CERTIFICATE OF LIABILITY INSURANCE CRUMB 1 02/22/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
SellersKuykendall , LLC (WP) HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1560 Orange Avenue, Suite 750 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Winter Park FL 32789-5552
Phone:407-894-5431 Fax:407-629-6378
Crum's Climate Control Inc.
Brian Wrong
980 Railroad Avenue
Winter Park FL 32789
weTi11/ =j _7-T0 3q
INSURERS AFFORDING COVERAGE NAIC #
INSURER AThe Ohio Casualty Insurance 24074 INSURER
Zenith Insurance Co 13269 INSURER
C INSURER
D INSURER
E THE
POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY
REOUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR
NSR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMBS GENERAL
LIABILRY EACH OCCURRENCE 1 , 000 , 000 PREMISES(
Eauccu.rIc.) 100,000 AXCOMMERCIALGENERALLIABILITYEK0065297332109/30/05 09/30/06 MED
EXP (Any one person) 10 , 0 0 0 CLAIMSMADEFX ] OCCUR PERSONAL
BADVINJORY 1,000,000 XEmployeeBenefitsBKO065297332109/30/05 09/30/06 GENERAL
AGGREGATE s2,000,000 GENL
AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG 2 , 00 0 , 000 17
POLICY X JEC7 LOC AUTOMOBILE
LIABILITY COMBINED SINGLE LIMIT ANY
AUTO Ea accident) BODILY
INJURY ALLOWNEDAUTOSSCHEDULED
AUTOS Per person) BODILY
INJURY HIREDAUTOSNON -
OWNED AUTOS Per arcideM) PROPERTY
DAMAGE Per
accident) GARAGE
LIABILITY AUTO ONLY - EA ACCIDENT OTHER
THAN EA
ACC ANYAUTOAUTO
ONLY' AGG EXCESS/
UMBRELLA LIABILITY EACH OCCURRENCE 1,000,000 A
X I OCCUR CLAIMSMADE US052973321 09/30/05 09/30/06 AGGREGATE s
HDEDUCTIBLE
XRETENTION $ 10 , 000 WORKERS
COMPENSATION AND X I TORY LIMITS ER B
EMPLOYERS'
LIABILITY Z048938604
09/30/05 09/30/06 EL EACH ACCIDENT 500000 ANYPROPRIETOR/PARTNER/EXECUTIVE E.
L. DISEASE - EA EMPLOYEE 500000 OFFICER/MEMBER EXCLUDED? If
yes, describe under E.
L. DISEASE -POLICY LIMIT 5 0 0 0 0 0 SPECIALPROVISIONSbelowOTHER
A
Property BKO0652973321 09/30/05 09/30/06 Contents $110,250 Spec/
RCV $500 Ded DESCRIPTION
OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE
HOLDER CANCELLATION OSBUDFL
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
THEREOF, THE ISSUING INSURER WILL NOTICE
TO THE CERTIFICATE HOLDER NAME Osceola
County Building Dept. IMPOSE NO OBLIGATION OR LIABILITY OF AN 1
Courthouse Square, Ste 1400 Kissimmee
FL 34741 REPRESENTATIVES. 4CORD
25 (2001/08) TO
THE V AILY IbWALL KIND
ION THE INSURER, ITS AGENTS OR 2
m
CORD CORPORATION 988 PLANNING
AND DEVELOPMENT
POWER OF ATTORNEY
Date: 14. 1 3 ' o(o
1 hereby name and appoint yncn-j-1(1a -be — Ances
of
I &UM!-5 amc= Cc)(= 1 to be my lawful attorney
in fact to act for me and apply to the
Building Department for a permit
for work to be performed at a location described as:
Section Township Range Lot Block
Subdivision
n
Address of Job)
Owner of Plo erty and Address)
and to sign my name and do all things necessary to this appointment.
Type or Print Name of Cad Contractor and Contractor's License Number
Signature of Certified
The foregoing instrument was acknowledged before me this day of
l (
XQ
by '
w<srsonall e/who produced
as identification and who did not take oath.
N
FIONA MONNOR
comm#eDa24>,a
State of Florida
r
F.xpir.s isnrtooa
Bwrded thm (600)6324254
m in Moride Nwery Assn., I= County
of............................................i
Seal
Notfry
Public, Orange County, Florida
P: rmit NulT,ber
Ps. cai Id.Ertific 3umber
Prepared bj':
Return to:
CA m cti-i Cone
W
N0171.GE.QF'.001V1: %'N:C!``1VI NT
State of
Oun.fy.,of` a
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CERTIFIED COPS o' W c
Ln CD
E
RTIDA' WCI
hn underslynE,d: hereby.'qiyes:notice:atiat: mprovement(s) will be made to certain real property, a 006
coc62nceIthChapter;7.13; 'FCo.rlda':S;fa.tutes, ths'following-information is 'provided In'th)s No.tice of Commencement.
D.esc.ripti.on of p:rap.erty;(legal description of the property, and street address if available)
C-.enbrai:.d:eserlp.tlon o.f Im-Overnent(s)
Owner information
Named-r-1
Address 2•I • ,r ,..t. Telephone Number
p VC Fax Number'.
Feo `Sim:pte Tl;tl.e Holder (if other thanowner shlown ab.ovnterest In Proporty: Name _
Address, Telephone Number
Fax Number
Con:trabtor '
Name:C-(-wYls C lpl
Su.re.ty:(if,any)
Nama`. Address
Ler.
d.e.r,-'(if 2ny) Name
Address_
y0-
7 - Z 3 - so;-i Telephone
Number. y - (cy[r Fax•Number Telephone
Number Fax
Number Amount
of -bond $ Telephone
Number Fax
Number Persons;
vithin:the:S.tat0 of Florida d.esighated by Owner upon whom notices'or other documents may b.e served:as.:provided 5y §713.13(1°)(a)7., Florida Statutes, NameAddress
Telephone Number Fax'
Number In
addition to hlmseff or herself, Owner. designates the following to receive a copy of the Lienor's Native as provid.ad::ln...§713.13(1•)(b), Florida Statutes, Name
Address,
Telephone Number Fax
Number Explra#
fo_ri::`da4e of..notice of. commencemont (the expiration date. is one year from .the date of recording unlessadifferent .date Is. specified): ig.
nEd1'i C1r . Signatureof0:',ner.:Note: psr: 71; , . must
sign .:.and•.no one else may be.per , lite d to sign in hisor'he' r stead_" - to
and.sbbscribedbefore me -this 1 day flf• ; 20 D (D • by prsori'
ally •known #o•m OR' pfod:uced' ific2tion. • _ Wised:
12/00.f6r 19_ to 20 of
Notary (notarial seal to appear. be slope ........ .....•...............
FIONA
O'COMNOR Trr.#
D00424343 4'':
f+s Lr:pires 5/1/2009 or --
kr. Bonded thru (500)432-4254 nnua
Flonda Notary Assn., Inc oq.o.uw .......................•......: TY
OF SANFORD- APR
2 1 2006 AND
DEVELOPM