2415 Stevens Ave - M17-002710 - AC SPLIT SYSTEMrip
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CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
D Application No:
Documented Construction Value: $ 9
Job Address: 2 415 Stevens Ave. , 32771 Historic District: Yes No
Parcel ID: 31-19 - 31- 5 2 4 -13 0 0- 0 0 9 0 Residential Q Commercial
Type of Work: New Addition Alteration Repair 0 Demo Change of Use Move
Description of Work: Replace the existing 3 ton straight cool split system
Plan Review Contact Person: Title:
Phone: Fax: Email:
Property Owner Information
Name Ameer Robinson Phone:407-409-8577
Street: 2415 Stevens Ave Resident of property? : Yes
City, State Zip• Sanford, FL 32771
Contractor Information
Name Associated Piping Services Phone: 407-859-4756
Street: 1023 29th St Fax: 407-859-3095
City, State Zip: Orlando, FL 32805 State License No.: CAC 1818 8 3 0
Arch itect/Eng1neer Information
Name: 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: 5th Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
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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 ofthe requirements ofFlorida 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'
be don n co
PrintOwner/Agent's Name
AVIT: I certify that all of the foregoing information is accurate and that all work will
nce with all applicable laws regulating construction and zoning.
Date Signature ofCon r/Agent Date
qk,z =-, yt-=Sft*
A..
kla4f1-2
ignatu a i?tmp&WSSION is (3Ci0 94f
EXPIRES June 12.2021
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Kenve'A
Print Contractor/Agent's Name
4" VD."t h-k
Signature of N tary-State of Florida Date
KIMBERLY A.
VANDERa306NotaryPublic - State of
Commission # FF 21
My Comm. Expires Mar
own to Me or
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.
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes No # of Heads Fire Alarm Permit: Yes No
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING:
COMMENTS:
FIRE: BUILDING:
Revised: June 30, 2015 Permit Application
1023 29th Street
0darA'6"FL,32805:
Offir*Z.(407) 86S4756 * Fax, (407) 85"0495
al subMitted to to I
xtAld Rmgan Blvd 241.5 Slevens,Avc
d,: K 3,2750 $anford, FL 32771
existing 3 towstraight cool split system to include,
Relocate.theoutdoor condensing unit so it is not in front ofth, ee outdoor electrical, disconnect switch
Reinsulite"tie copper reft*ration. piping with the required W thick ins
Provide & install a That switch in the air handkr unit
Provide,& install an electrical disconnect switch -for the indoor air handier unit
Provide & replace -the _'Wamp, circuit breaker -with the required 257 atop size
de -nsim unitProvide & install Tockible caps on theaceess ports,owthe cori- -
All the above ;listed work- will be required to by-themeclianical code' to be able to pass inspection
All,material, labor & permitincluded
All ;material is guarariteed.to be as specified and the work to tic porforined in j=ordance with the draNvings and
specifications submitted for above ,work ,and completed in a workmanlike nmmcr'f(* the sum of ($950.00) W-Ith
paynwnts as follows-.."
00'4ue:txpowcompleitioffof work And
alttmtion ordeviation -hom above specifications'*0%ing extra ciogiswill beexecuted onlyupon-written orders. and will
become an e.,dra cliarge over and above the original estiawke. All agrecrucift pontiggpit upon strikes,. accidents otdel
delays beyond ourcontrol. Owner to carry fire, tomado'And oth&.necess , ary insurance upon above Work. Workm
en's,,Compensatiou;and. Public Liability Insurance to be taken out by Associated Piping Services,;Inc. Respectively
submitted by
Associated Piping'.Sirvices,'Inc. ACCEPTANCE OF PROPOS
M The above. prices,
specifications and conditions are satisfactory and are, hereby accepted. Ass6ciate& Piping servjcc,s;.,fiIc:.
is a_uthdri to dothe work- as specif ied, Payment Will W made, as outlined above. Accepted by Signature
Date_fz
C AC1818&30
15049
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: V bp
I hereby name and appoint: Dominick D' Ambrosio
an agent of: Associated Piping Services
Name of Company)
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):
The specific permit and application for work located at:
2415 Stevens Ave, Sanford, FL 32771
Street Address)
Expiration Date for This Limited Power of Attorney: 12 / 31 / 17
License Holder Name:
State License Number:
Kenneth J. Smith
CAC1818830
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF &r a,, e-
The foregoing instrument was acknowledged before me this 2,P day of ,
2007, by XC'j ,, o' Sri, who is finally known
to me or o who has produced as
identification and who did (did not) take an oath.
Notary Seal)
Signature
c". ^ "J7 Varyooi v
Print
or type name ky
Pia, KIMBERLYA. VANDE]2019 Notary
Public -
State of o L Notary Public
State Commission No. ff 2/3o6 Commission # FF
2M Commission Expires: /)fir 20/1 1'9rR OFF°
p , My Comm. Expires Mary p °, Bonded through National
N Rev. 08.12)