147 Wornall Dr - M18-002918 - HVACCITY OF
S ORD
FIRE DEPARTMENT
Building & Fire Prevention Division
PERMIT APPLICA TION
Application No: / d - d 9 / d
Documented Construction Value: $ 5 4o7s;
Job Address: 10 06c"t ll br. SG.+1-o c0 ILL. ( Historic District: Yes No
Parcel ID: 33 / g- 30 - Sly- o&06 - O,P V6 Residential(Commercial
Type of Work: New[] Addition[:] Alteration Repair Demo® Change of Use Move
Description of Work: HyA e s r as - S <roN Ae,4 Pb.w n. / 1 Sea --
Plan Review Contact Person:
Phone: Fax: Email:
Property Owner Information
Name DONtuS Sa dd /,er—.
Street: 1147 worsitt(1 10.r.
City, State Zip: Sri..., A-d , ML -7Z T) l
Name 4444 4J1
Street: I I :S Sly 4Jz./
OF
City, State Zip: Ifo/Al Sa^•,-.s S01
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Title:
Phone: UV') - 314.- &S7Z-2 Resident
of property? : Contractor
Information Phone: '
321 - 401- 3113 Fax:
407- t!a75- 410SI State
License No.: C4 C-If ie T i Architect/
Engineer Information 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. 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 or that date: 61" Edition (2017) Florida Building Code Revised:
January I, 2019 Permit Application
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 pen -nit 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 construe 'on >I zoning.
i
Signature of Owner/Agent Date rgnature ofContractor/Agent Date
Print Owner/Agent's Name
of Date
Notary Publk - StateofRodda
Lne CommissiontGG 13S226
My Comm. E>tpires Sep 2, 2021
Owr/ gen is rrra iry wn to Me or
Produced ID i/ Type of IDf::_
PA? ( Sr
Print Contractor/Agent's Name
r0&.oZ l Y
Signature Dale-
DEBBIE BLANTON • k = MY COMMISSION 0 FF 176648
EXPIRES: February 25, 2019
Drnded Thru Nolar, puDFc Unden:Tite,
Contractor/Agent is Personal] flown to Me or
Produced ID Type of ID , lie -
glal
BELOW IS FOR OFFICE USE ONLY
Permits Required: Bu.tilding Electrical Mechanical" Plwnbing Gas Roof
Construction Type: Occupancy Use: Flood 'Gone: -
Total Sq Ft of Bldg: 1-%1A9 Min. Occupancy Load: of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
Fire Alarm Permit: Yes No
WASTE WATER:
FIRE: BUILDING:
Revised: January I, 2018 Permit Application
Proposal Date 6/26/2018 lob Number 460785922 AAA All Brands Appliance, LLC
Customer Name 9426 Royal Vista Avenue
Donna Saddler AAA All Brands Appliance Clermont, FL34712
Phone 321.414-3223Customer's Home Phone Customer's Work Phone NA
407) 324-6557
Email Allbrandsorl@gmail.com
Street Address 147 Wornall or ESTIMATE AND PROPOSAL contractor License
Heating & Cooling
rAc1918311
City State Zip Code 32771
Sanford FL IsInstallationwithindrylimits?
Countylines InstallationAddressCounty— Seminole Billing
Address (if different from above) City State Zip Code Technician Brian
Description
of the Project and Description of the Significant Materials to be Used and Equipment to be installed SYSTEM
INFORMATION: Equipment Brand: Goodman 14 Seer Heat Pump 3 ton With 5 KW heaterWill Register for extra 5 yearpart warranty. Will submit Information
to Customer. Total of 10 year parts warranty 2 R-410A EQUIPMENT
SPECIFICATIONS: FURNACE FUEL (Gas/OII/LP Gas/Electric): _ Electric Existing
New Model p of new component AFUE (up to): Heating BTU: _ 5 FURNACE/
FAN COIL ELECTRICAL: CONDENSER
UNIT 2 CONNECT TO EXISTING ELECTRICAL EVAPORATOR
COIL INSTALL NEW AMP MAIN PANEL PACKAGE
UNIT NEW DISCONNECT FURNACE CONDENSER Q
THERMOSTAT Honeywell T6 NEW GFI OUTLET ATTIC LIGHT& RECEPTACLE HUMIDIFIER
Other: Install new whip and locking caps, Straps and SS2 float switch AIR
CLEANER DUCT WORK: UV
LIGHTQ RE -USE EXISTING DUCT SYSTEMEVAP
COOLER INSTALL NEW DUCT SYSTEM WITH 9 NEW RUNSMISCELLANEOUS:
Q REBUILD PLENUM up to 12 inch d
LINE SET J PAD 36x36 ( NEW TRUNK LINES) 2
DRAIN LINE CONDENSATE PUMP NEW RETURN GRILL(S) X X AUXILIARY
DRAIN PAN Other Q EXISTING RETURN GRILL SIZE INSULATION
REPLACE REGISTER (5) 0 Batt/
Blown): R-Value DUCT CLEANING Other:
FLUE
VENTING AND/OR CHIMNEY: Ouse existing vent or chimney Install new chimney liner Size: PVC
Vent Pipe for High -Efficiency Furnace Horizontal Verdol Type•B Vent Pipe [3tainless Steel Vent Pipe 1
Pipe Installation 2 Pipe Installation Combustion Air Existing Modify SPECIAL
INSTRUCTIONS: We will be removing old equipment per epa regulations, Installing necissary componets for code
requirements. Start up and test after install. New base for platform will be installed as well. Installaiton of system includes
all code required items such as locking caps, float switch, tie downs, and new hurricane pads. We will register the
equipment to the buying customer to have the extended warranty. In this estimate, CosVo or3 ton 14 seer system is $
5,275. If you want to save some money we do have cash price. Total cash price is , edit From ahs is 604
towards upgrade which we will collect as down payment. Total am Lint after collected cre 't is $4,571 by credit
card or Finance ory Cash or Check. Please let us know t opt' n ou choose. ty All
of the above check boxes and "Special Instructions" section have been reviewed and Customer's Initials explained
to me. Page
I of 3
NOTICE TO OWNER
1. DO NOT SIGN THE AGREEMENT IF ANY OF THE SPACES INTENDED FOR THE AGREED TERMS TOTHE EXTENT OF THE AVAILABLE INFORMATION ARE LEFT BLANK
2. YOU ARE ENTmLED TO A COPY OFTHIS AGREEMENT ATTHE TIME YOU SIGN R. KEEP ITTO PROTECT YOUR LEGAL RIGHTS.
3. THIS HOME IMPROVEMENT CONTRACT MAY CONTAIN A MORTGAGE OR OTHERWISE CREATE A LIEN ON YOUR PROPERTY THAT COULD BE FORECLOSED ON IF YOU
DO NOT PAY. BE SURE YOU UNDERSTAND ALL PROVISIONS OF THIS CONTRACT BEFORE YOU SIGN.
4. YOU MAYCANCELTHISTRANSACTIONATANYTIME WITHIN48 HOURSOF THE DATE OF THISTRANSACTION. IF YOU CHOOSE TOCANCELAFTER THIS PERIODYOU
WILL BE CHARGED A $250 RESTOCKING AND HANDLING FEE
FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND
PAYMENT MAY BE AVAILABLE FROM THE FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND, UP TO A LIMITED AMOUNT IF YOU LOST MONEY ON A PROJECT
PERFORMED UNDER CONTRACT, WHERE THE LOSS RESULTS FROM SPECIFIED VIOLATION OF FLORIDA LAW BY A LICENSED CONTRACTOR. FOR INFORMATION ABOUT THE
RECOVERYFUND AND FILING A CLAIM, CONTACTTHE FLORIDA CONSTRUCTION INDUSTRY LICENSING BOARD ATTHE FOLLOWING TELEPHONE NUMBER ANDADDRESS:
CONSTRUCTION INDUSTIRES RECOVERY FUND,1940 NORTH MONROE STREET, TALLAHASSEE, FL 21288; TELEPHONE: (850) 921.6593
YOUR PROPERTY OR PROVIDE MATERIALS AND SERVICES AND ARE NOT PAID IN FULL HAVE A RIGHT TO ENFORCE THEIR CLAIM
FOR PAYMENT AGAINST YOUR PROPERTY. THIS CLAIM IN KNOWN AS A CONSTRUCTIONS LIEN. IF YOUR CONTRACTOR OR A
SUBCONTRACTOR FAILS TO PAY SUB CONTRACTORS, SUB -SUBCONTRACTORS, OR MATERIAL SUPPLIERS, THOSE PEOPLE WHO ARE
OWED MONEY MAY LOOK TO YOUR PROPERTY FOR PAYMENE, EVEN IF YOU HAVE ALREADY PAID YOUR CONTRACTOR IN FULL. IF
YOU FAIL TO PAY YOUR CONTRACTOR, YOUR CONTRACTOR MAY ALSO HAVE A LIEN ON YOUR PROPERTY. THIS MEANS IF A LIEN 1
FILED YOUR PROPERTY COULD BE SOLD AGAINST YOUR WILL TO PAY FOR LABOR, MATERIALS OR OTHER SERVICES THAT YOUR
CONTRACTOR OR A SUBCONTRACTOR MAY HAVE FILED TO PAY. TO PROTECT YOURSELF, YOU SHOULD STIPULATE IN THIS
CONTRACT THAT BEFORE ANY PAYMENT IS MADE, YOUR CONTRACTOR IS REQUIRED TO PROVIDE YOU WITH A WRITTEN RELEASI
OF LIEN FROM ANY PERSON OR COMPANY THAT HAS PROVIDED TO YOU A "NOTICE TO OWNER." FLORIDA'S CONTRUCTION LIEN
IS COMPLEX AND IT IS RECOMMENDED THAT YOU CONSULT AN ATTORNEY.
Customer's Signature Date
Accepted by All Brands Appliance, LLC ("AIL Brands") on
Customer's Signature Date
42%41,Zce by: 2
Date Management Representative
Page 3 of 3
POWER OF ATTORNEY
0?8- C90r8
Date
I hereby name and appoint ph; ; I TD
to be my lawful attorney in fact to sign my documents pertaining to permits for the Lake County Building
Division. (Check and complete one of the toilmving.)
o To sign for any and all, documents unbl further notice.
OR
IM To this specific job for work to be performed at
1147 W 6rijA f( Dr. San 4a . 09, 32 771
Alternate Key # Section Township Range
Lot Block _ Subdivision L GC6&,n Fpt C14.6 Arg. License #
S (
k Name
of Contractor State
of Florida County
of Lake The
foregoing instrument was acknowledged before me this CKQ day of 20 , by
rI U Q. !" J 1 . who is personally known to me or has produced f'
l I p L as identification and who did ® or did not take an oath. SEAL)
bkh-Z 42 Notary
Public (Signature) 44,
CorrontwwOQousm Eow '
3.21 1 an6w"
I kV9W basest= K OKioe
of Building Servxes Page 1 of t BF33 Power of Attorney Revised September
29, 2017