145 Lakeside Cir 5546 HVACREGOVV-V
JAN182017 CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
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Documented Construction Value: $
Job Address: s Lcui c I llA- C 1 ka-t- Historic District: Yes
Parcel ID: (( 2-0 • 0' E5 61 ` 0W cl-o- 0Q Zoning:
Description of Work: -i H C Z 11 S V Cn - Uo-
CPlanRevieContactPerson: I Lc IAcJL Title
Phoe vl rt Z QZ (Fa q 2=U< <
E-mail: ((J-e/
Property Owner Information
Name c- GA vL-u_ -1--1
Street: 1 `-lam 1 cL%-- C
City, State Zip: E-1, 62-9-1
Name "L_)6--+-'I
Street- 7!f) •
City, State Zip- 1
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Building Permit 0 qq — Square Footage:
No. of Dwelling Units:
Electrical
Phon : C w
Resident of property?
Contractor Information
A
ss4 ce -
No
PhZ
Fax:
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State License No.: OP"C l U Zu
Architect/Engineer Information
Phone:
Fax:
E-mail
Mortgage Lender:
Address:
PERMIT INFORMATION
Construction Type:
Flood Zone:
Plumbing
No. of Stories:
New Service - No. of AMPS: New Construction - No. of Fixtures: _
Mechanical Z uct layout required for new systems) Fire Sprinkler/Alarm No. of heads:
Shall be inscribed with the date of application and the code in effebt as of that date (Code 2010 FBC) 731.135(5)(6) Florida Statutes.
REV 07.14
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. 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 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. 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.
Signature of Owner/Agent
Print Owns/Agent's Name
Date
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING: UTILITIES:
ENGINEERING:
COMMENTS:
I1A
ontractor/Agent Da
J %
Print or/Agent's Name
Sign a of Notary -State ofFloridaf Date
r'i Notary Public State of Florida
Anita C Witherspoon
c My Commission FF 2
o, n Expires 06/03/2019
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
BUILDING:
Shall be inscribed with the date of application and the code in effect as of that date (Code 2010 FBC) 731.135(5)(6) Florida Statutes.
REV 07.14
Certificate of Product Ratings
AHRI Certified Reference Number: 7995113 Date: 1/17/2017
Product: Split System: Heat Pump with Remote Outdoor Unit -Air -Source
Outdoor Unit Model Number: GSZ140301 K*
Indoor Unit Model Number: ARUF31614A*
Manufacturer: GOODMAN MANUFACTURING CO., LP.
Trade/Brand name: GOODMAN; JANITROL; AMANA DISTINCTIONS; EVERREST; ONE HOUR AIR
CONDITIONING AND HEATING; ENERGI AIR; FRANKLIN
Series name: GSZ14
Manufacturer responsible for the rating of this system combination is GOODMAN MANUFACTURING CO., LP.
Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air -Conditioning and Air -Source
Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third
party testing:
Cooling Capacity (Btuh): - 28000 --
EER Rating,(Cooling):- - 12.00
SEER Rating (Cooling):' 14.00 -
Heating Capacity(Btuh) @ 47 F: 27800 . ,.
Region IV HSPF Rating (Heating): 8.20
Heating Capacity(Btuh) @ 17 F: 16200
Ratings followed by an asterisk (*) indicate a voluntary rerale of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate.
DISCLAIMER
AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for,
the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the
unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the
directory at www.ahridlrectory.org.
TERMS AND CONDITIONS
This Certificate and Its contents are proprietary products of AHRI. This Certificate shall only be used for Individual, personal and
confidential reference purposes. The contents of this Certiflcate may not, in whole or in part, be reproduced; copied; disseminated; XMenteredIntoacomputerdatabase; or otherwise utilized, in any form or manner or by any means, except for the user's individual,
personal and confidential reference. AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
The information forthe model cited on this certiflcate can be verified at www.ahridirectory.org, click on "Verify Certificate" link we make life better'
and enter the AHRI Certified Reference Number and the date on which the certificate was issued,
which is listed above, and the Certificate No., which is listed at bottom right.
131291578607391563
2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: