136 Rockhill Dr 17-315 HVACE`+r=IV CITY OF SANFORD
1 2017
BUILDING & FIRE PREVENTION
FEB PERMIT APPLICATION
gY Application No: / 1. J /
r
Documented Construction Value: S 5 a
Job Address: 136, Y > > Historic District: Yes No
Parcel ID: 33 ^11-3 0 " 4 " o r ii a Residential Commercial
Type of Work: NewE-Addition Alteration Repair Demo Change of Use Move
Description of Work: A / at a s L &_ys
Plan Review Contact Person: Title:
Phone: 3 8-GG>5, Fax: r(k — (,6_6,WEmail: t Gi;" •C-64Y
ItProperty Owner Information
n y
Name Phone:,f J
Street: n >F ti. Resident of property?
City, State Zip: 56W. W.,
1•Centr`.actor Information
Name rltllod ZA. Phone:
Street: ? Fax:
City, State Zip:-7 7/> State License No.:C-o
Architect/Engineer Information
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Phone:
Fax:
E-mail:
Mortgage Lender:
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. 1 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: 50 Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
NOTICE: In addition to the requirements of this permit, there .may be additionaf rdstridtions applicable to this property that may be
found in the public records of this county, and there may be additional permits required froi 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 in compliance with all applicable laws regulating construction and zoning.
1/4 4 —/—/
7
Signature of Owner/Agent Date Signature of ntractor/Agent Date
1 C14/ c
Print Owner/Agent's Name Print Contractor/Agent's Name
n , , n ..fl
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
pJId/QrdZO
9oIt01111tnt tMaf o11 Ado lbtttolNttlete
Contractor/Agent is V Personally Known to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing[] Gas[] Roof `-
Construction Type: Occupancy Use:
Total Sq Ft of Bldg: Min. Occupancy Load:
Flood Zone:
of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures,
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised. June 30, 2015 Permit Application
Property Record Card
ed&=
i
Parcel: 331930516.0000•t220 KK,AA1{IIJFSJ
t Owner. SHIRLEY ANDREA C Property Address: 136
ROCKHILL OR SANFORD. FL 32771 Parcel Information Parcel
33319-30-
516-0000-1220 Owner SHIRLEY ANDREA
C Property Address 136
ROCKHILL OR SANFORD. FL 32771 Mailing 136 ROCKHILL
OR SANFORD, FL 32771.7747 Subdivision Name COUNTRY
CLUB PARK PH 2 Tax District 1-
SANFORD DOR Use Code
01-SINGLE FAMILY Exemptions 00-HOMESTEAO(
2007) Legal Description LOT
122 COUNTRY
CLUB PARK
PH 2 PS 54 PGS
22 THRU 24 Taxes Value Summary
2017
Waking Values
2016 Carl
ad
Values Valuation Method
CostlMarket
Cost/Market Number of Buildings
1 1 Depreciated Bldg Value
141,077 135.392 Depreciated EXFT Value
5288 300 Land Value (Market)
32.000 32.000 Land Value Ag
1$173.365 JusilMarket Value •• 167.692 Portability Adl Save
Our Hanes
Adj 1$49.493 44.681 Amendment 1 Adj
i PSG Adj s0
SO Assessed Value 1$
123.872 13123.011 Tau Amount without
SOH: $2,548.12 2016 Tax Bill
Amount $1,6S2.48 Tax Estimates Save
Our Homes
Savings: $89S.64 Does NOT INCLUDE
Non Ad Valorem Assessments Taxing Authority Assessment
Value I Exempt Values Taxable Value Schools 123.872
25.000 98.872 City Sanford 123.
872 SW.000 73.872 SJWM(Sasnt Johns
Water Management) 123,872 550,000 73.872 County Bonds 123.
872 50.000 73,872 County General Fund
123.872 50,000 73,872 Sales Description Date
Book
Page Amount I Quarmed VerJlmp WARRANTY DEED 4ni2006
t16217 285,000 Yes Improved SPECIAL WARRANTY DEED
511/2000 0365t QZj$ 123.000 Yes Improved WARRANTY DEED 2/
1/2000 IQ= 523.500 Yes Vacant Find CompmbN Sala$
Land Method I
Frontage
I Depth Units Units Price I Land Value I I LOT I I11 $32,000.00 I s32.0o0 Building Information
DeltonalDeBary
366) 668-8752
Daytona
M) 761.8319
UC d CAC050422
DoUnd/Omge City
386)73"M
Brovesd County
321) 733-2W0
Sanford Orlando
407) 322-0199 (407)628-5748
New Smyrna
386) 427 9149
ALL OTHER AREAS: 1-888-MID-R AC
643-3S22
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slab foroondenser unit Kl
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WARRANrYearAND GUARANTEES duntrs
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ystdin! year wanany on 80 otiner Iklanulakau R r parts. tree s6rvias
handata of start pp ducted () flierb®dk grill waniW on a9 other pads In otalled by Mll -k AIC, INC. platform ReomnedPlenum
Jo) Mastic cover halters, Tripped Bracken; or WtebhtenanOe tnarrangrtorai rnalfoNy
MISCB. ANEOUS
OR EXTRAS: t o,
Weagree
to hwdsh and Install the above described labor and materials on the terms k dicoted below: It Is
agt ed OW d putdtaser releases the seller tram surd that the seder assumes no liability and shell not be iesponsUNe for any loss, damage or delay ftesed bybactBtikmal(dkka mischief. pidoot liam of govemmient, nes, ads ofGG od wologicn, gotyp a
commotion, vjWer
damage, dot dvl ges. nuclear
I
a
y daurvi, mold, disputes arise
it is agreed to by the purchaser and seller that they will be settled by a medalor event of consequential damages. N any cairns or PAYMENTTYPE: CHECK
O CASH !j C'CREDITCARDThe customer
acbmAedges that prior to dgning this proposal he has $ 5Z SO read The
terms and conditions contained herein and hereby accepts $ - Z50 }per*b)k Oft proposal
including the cpndNon th ons e revrateside hereof which $ 2 $V'J" Rep" nd are a
partofthepropcsekafurtheragreestomake payments as 100% WHEN E(XJIPMEW IS follows: INSTALLED $ FROM wCLUMSALLM3000M'%
FAMATE3AIm
INOEWIVEs BUYER'S
RIGHT TO
CANCEL' It this Is a
home solicitation sale, and If you do not want the gpbeb or services, you may cancel tlds egnmwd by maFing a irotioe to ere sellBr. This notice must be posbnadied
before midnight of the OW business day aftyou dgn the agent If you cancel r9ertlent. The seller may keep all or part of
any.cash dpm payment; not rD snood the lesser of 6 perbent of the Cash price or ean Dom! th' Purchaser Estimator, ...--
W Rsoommend the
Power Compariy Test Your Ducts For leaks FPL 0 DUKE ENEMY
PHONE 1-er-712-3413 0
Certificate of Product Ratings
AHRI Certified Reference Number: 9155179 Date: 1/27/2017
Product: Split System: Heat Pump with Remote Outdoor Unit -Air -Source
Outdoor Unit Model Number: 25HBC536A"030'
Indoor Unit Model Number: FX4DN(B,F)037L
Manufacturer: CARRIER AIR CONDITIONING
Trade/Brand name: CARRIER
Series name: COMFORTIS HP
Manufacturer responsible for the rating of this system combination is CARRIER AIR CONDITIONING
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): 34800
EER Rating (Cooling): 12.00
SEER Rating (Cooling): 15.00*
Heating Capacity(Btuh) @ 47 F: 34600
Region IV HSPF Rating (Heating): 8.50
Heating Capacity(Btuh) @ 17 F: 21400
Ratings followed by an asterisk I') 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.shridirectory.org.
TERMS AND CONDITIONS
This Certificate and Its contents are proprietary products of AHRI. This Certificate shall only be used for Indlvtdual, personal and
confidential reference purposes. The contents of this Certificate may not in whole or in part be reproduced: copied; disseminated;
entered into a computer database: 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 G REFRIGERATION INSTInM
The information for the model cited on this certificate can be verified at www.shridirectory.org. dick on 'Verify Certificate' link „v 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
02014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 131299962945522015
SEUINOLE COUNTY MOLT/ JURISDICTIONAL
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date:
I here
an ag
to be my lawful attomey4n-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):
All permits and applications submitted by this.contractor.
6"""The specific permit and application for 'work located at:
17P l%. -Lil ^II' n,.
Expiration Date for This Limited Power of Attorney:
License Holder
State License Numbe
Signature of License
STATE OF FLORI A`
COUNTY OF
The foregoing instrument was acknowledgedTiA
re me this —Loy of "&'r
20_, by I 1 11 (' 4 k . 1 who is Erppersonally known to me or
O who has produced as identification
and who did (didjnt) take an oath.
nt 00 Notary
OrMAMIk2w
lOr"1uNaAti1P1 **Wb0
L o S
Print or type Notary name
Notary Public - State of _
Commission No.
My Commission Expires:
City of Sanford
HVAC Permit Application Checklist
All permit application packages must be complete prior to acceptance. You must check each
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.
A Copy of a contract, signed by the contractor and the property owner, indicating the documented
construction value
Copy of applicable contractor's license issued by the State of Florida (if the contractor is the
applicant).
fd' 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.
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).
O Completed and signed Owner Builder Statement / Affidavit (if the owner is the applicant).
O 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.
O 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 H VAC 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