1621 Pine Oak Trl 17-1441; AC CHANGEOUTCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: / r / qq /
Documented Construction Value: $ 3 Y U - . ( )--
Job Address: f ®,2; _ Tnft Historic District: Yes No El
Parcel ID: I? —go "001n6 ` Q 116 Residential 0' Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work: A Ldh,,m4 G a, ' --5Z.G 16ic- Sl Z Plan
Review Contact Person: Title: Phone:
Fax: Email: Property
Owner Information Name
I-q, ( r Phone: Street:
a UV`C. &2 1C TA, Resident of property? City,
State Zip: S,_\L La w"'I Contractor
Information Name
19V4 Vi VU,1JA Phone: 407" 77V,,a-3cDL_) Street:
ipo -6UV_ %/(,a Fax: ` City,
State Zip: n r'l - 3 7 Cv State License No.: l a/
G`3 Architect/
Engineer Information Name: (
k 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: 5ch Edition (2014) Florida Building Code Revised:
June 30, 2015 Permit Application
X
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 inyo pliance with all applicable laws regulating construction and zoning.
yl SI717
Signature of Con for/Agent Date
Print Contractor/Agent's Name
Datecra+..
705179%6
Signature of Notary -State of FloriW
LINDA L. MCKE
MY COMMISSION #
EXPIRES: Octobe
Y'Py' LINDA L. MCKENZtE
MY COMMISSION # FF 051796
Bonded Thro Notary Publ
y'• dF EXPIRES: October 23, 2017
of.•' Bonded Thru Notary Public Underwriters
C7 - 1-7
Date
Owner/Agent is Personally Known to Me or Contractor/Agent is — Personally Known to Me or
Produced ID Type of ID Produced ID Type 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:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
SCPA Parcel View: 18-20-31-509-0000-0110 Page 1 of 2
f.
c
Property Record Card
Parcel: 18-20-31-509-0000-0110
Owner: GIRARD ALAIN
Property Address: 1621 PINE OAK TRL SANFORD, FL 32773
Parcel Information
Parcel 18-20-31-509-0000-0110
Owner GIRARD ALAIN
Property Address 1621 PINE OAK TRL SANFORD, FL 32773
Mailing 1621 PINE OAK TRL SANFORD, FL 32773
Subdivision Name MAGNOLIA CLUB
Tax District St-SANFORD
DOR Use Code 0103-TOVVNHOME
Exemptions
my GIS
Legal Description
LOT 11
MAGNOLIA CLUB
PB 67 PGS 75 - 79
Building Information
Value Summary
2017 Working
Values
2016 Certified
Values
Valuation Method Cost/Marrkkett Cost/Market
Number of Buildings 1 6 1
Depreciated Bldg Value 102,209 I $90,281
Depreciated EXFT Value—
Land Value (Market) 25,500 j $21,000
Land Value Ag
Just/MarketValue" 127,709 111,281
Portability Adj
Save Our Homes Adj s $0 j $0
Amendment 1 Adj I $7,905 i $2-- _368
P&G Adj 0
Assessed Value ^— 119,804 108,913
Tax Amount without SOH: $2,201.00
2016 Tax Bill Amount $2,201.00
Tax Estimator
Save Our Homes Savings: $0.00
Does NOT INCLUDE Non Ad Valorem Assessments
Is Bed/Bath count incorrect? Click Here.
I Description I I Fixtures I Bed I Bath I Base Area I Total SF I Living SF I Ext Wall Adj Value I Repl Value I Appendages
http://parceldetail.scpafl.org/ParcelDetailInfo.aspx?PID=l 8203150900000110 5/15/2017
McKenzie's General Repair Service
Inc./Pride
PO Box 716
Sorrento, FL 32776
CAC1816534 / CGC1518635
EC13OO4O3O / CCC1325723
Customer Phone I Customer E-mail
407-923-4504 agjiji@aol.com
Qty Description Rate Total
Replace existing air conditioner with new heat pump system manufactured by
Carrier Corporation
Provide & install new backlit Honeywell thermostat
Flush out existing lines & reuse copper line set
Install new filter back grill at top of stairway 3,571.00 3,571.00T
Sales Tax 6.50% 232.12
TEwvis
I Total
We hereby propose to furnishlabor and materials- complete in accordance with the above $3,803.12
specifications, for the sum of this proposal. Deposit of 50% required upon acceptance. With remaining
payment to be made through normal completion draws. All materials are guaranteed to be as specified.
All work to be completed in a workmanlike manner according to standard practices, any alteration or PtOrte #
deviation from above specifications or changes requested by governing agencies or owner involving
extra costs, will be executed only upon written orders and will become an extra charge over and above 407-814-7775
the price added to price above. All agreements contingent upon strikes, accidents or delays beyond our
control. This proposal subject to acceptance within 30 days and is void thereafter at the option of the Fax #
undersigned.
407-814-7745
PTANCE OF PROPOSAL
The above prices, specifications and c s are hereby a ted. You are authorized to do the
work as specified. Payment will b outlined abov E-mall
ACCEPTANCE SIGNATU .ter ATE:
If A mckenziesgrsinc@centurylink.net
City of Sanford
HVAC Permit Application Checklist
of All permit application packages must be complete prior to acceptance. You must check each
Au:a box to the left or indicate n/a on this submittal. A complete application package shall
include the following:
Building Permit Application completed, signed and notarized. Application must include correct address
and complete parcel I.D. number.
Copy of a contract, signed by the contractor and the property owner, indicating the documented
construction value
C1 Copy of applicable contractor's license issued by the State of Florida (if the contractor is the
applicant).
A site specific notarized power of attorney shall be required from the licensed contractor if
he/she appoints an employee of his/her company to sign the permit application as the contractor.
I Certificate of insurance indicating worker's compensation insurance coverage and naming the City of
Sanford as certificate holder, or a copy of a worker's compensation exemption issued by the State of
Florida (must be submitted with each application if contractor is the applicant).
Completed and signed Owner Builder Statement / Affidavit (if the owner is the applicant).
One (1) copy of equipment sizing calculations — for new construction installations:
o Residential - ACCA Manual J-2003 or other approved heating and cooling calculation
methodology.
o Commercial - ACCA Manual N-2005 or other approved heating and cooling calculation
methodology.
Addition or alteration of duct work, including new construction installations, requires two (2) copies of a
floor plan (duct layout) showing the location of the ducts, the size of the ducts and the register sizes.
This will require a plan review
These guidelines were compiled to assist the applicant in preparing a HVAC change out permit application and
may not be complete. The applicant is required to meet all City of Sanford, state, and federal code
requirements.
Revised: February 2015
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:,_
I hereby name and appoint:
an agent of FNE;g4cl—
Name of mpany)
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):
JR All permits and applications submitted by this contractor.
or
0 The specific permit and application for work located at:
Street Address)
Expiration Date for This Limited Power of Attorney:
License Hol
State Li.cens
Signature of
STATE OF
COUNTY(
The foregoing instrument was ac nowledged before me this of
201 , by who i ersonally known
to me or 0 who has produ
identification and who did (did not) take an oath.
Notary Seal)
19PeUNDA L MCKENZIE
MY COMMISSION # FF 051796
EXPIRES: October 23, 2017
Bonded Thru Notary Public Underwriters
Rev. 8/06/13)
a'rinda L. Mcl(enaie
Print or type name
Notary Public - State oL vim
Commission No. T— ' 1 7 R (a
My Commission Expires: