1180 Purdue Ln - M17-002615 - HVACCITY OF SANFORD
AUG 2 209 BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: S I I .
Job Addr.ess:,'t ! l tr LO - Historic District: Yes No
Parcel ID: 2-'D"' 3b ` 5PZ- - W I lqo Residential [A Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use kfove
Description of Work:c OAA+ 'di'JINIe ('01yy0 2 . ()2W -Seey Plan RevieNv
Contact Person:D*flryl (F YI ?_ Title: Phone.'--1"
Email: Property Owner
Information Name ff
r
I
ff) UAW Phone: Street: Ll
ry Residentof property;' City, State
Zip: L Contractor Information
Na vv
We- ! l Phone: 51 _ r Street: ,ft
Faz: J ? City, State
Zip: C State License :No.. f;i 9 I V Architect/Engineer
Information Name: Street:
City,
St,
Zip: Bonding, Company:
Address: Phone:
Fat:
E-
mail:
Mortgage Lender:
Address: NVA11NING
TO
0WN ER: l OI R F \ILIL RE TO RECORD .k :NOTICE OF C'OXIMEXCE:.N1ENT NIAN REst ur IN, YOIR PAYING TNN
ICE FOR I,NIPROVENIE.NTS TO 1OI: R PROPERTY. a NOTICE OF CONIMENCEMENT MIST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION'. IF YO1.1 INTEND TO OBTAIN-' FINANCING, CO\
SI'LT NVITI-I YOI R LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Application
is
het bv made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced pried-
to the issttanc e of a permit and, that all work will be performed to meet standards of all laws re-Ulatint, crvinstructiott in this
jurisdiction. I understand that a separate hermit must tie secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers,
heaters, tanks, and air conditioners, etc. F:BC
10.3 Shull he inscribed sith the date of application and the code in effect as of thatdate: S'11Edition (2014) 1.lorida Building Cwle ReNised lame "(1.
2015 hermit:Applicau011
WARNING TO OWNER., YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR IMPROVEMENTS TO
YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
NOTARIZED OWNER SIGNATURE REQUIRED ONLY IF THIS WORK IS NOT PART OF
A PROJECT WITH AN ISSUED BUILDING PERMIT.
Signature
Owner or Agent (including contractor)
The f0l-e-Oinly illStrURIC11t was acknowled,ed before
ine the
i I11 by who is
I)ersonally known to me and who produced
who did not take an oath.
Notary as to Owner
Commission No.
State of FL. County of
My Commission expires
SEAL)
as identification and
SiRoatur
C,'Cont if/
The foregoing instrument was acknowledged before
me the
K 12Z /-7 by who is
personally known to me and who produced
as identification and
who cli(I not take an oath.
Nptav, as t ractor
Co lilt 'lon6 L-1
N1q. S e- LUMP
St t fl-L County of9G'! nblC—
Nt/ly Colilinissio " n expires: pires:
101 2-Q I -Zb
SE, WAN RODR1=
266MyCOMMISSIONA" EXPIRES October 24. 2020
Pursuant to Florida State Statute 713.135(7) — All signatures must be notarized.
S:\BLlilding Div is ion\FO RM S\BLDG\AP PLICATION\New Electrical Application 11/20/13
8121 /2017 ServiceOne Air Conditioning and Plumbing Mail - Signed proposal. Walker job
t
rim 755W. Road 4, Sulte•U LonUv000d,
FL32750serv,c Ptrona: (401)331.6!AQ Taa:(407)3-11-638t41t7 i
i i r. , , r,i iir1iiir1, State Com a CAC1613760&CFCA428376 Customer: Walkor
Rnu hate: 0r21r2ol r Brittany Job
Addrass:
1180 Perdue Lano phonae 467-87B.8 2 Sanford, Fl.
32771 We, Service0no
Air Conditioning & Plumbing propose to furnish, install and service the heating andJur air conditioning
products and related equipment for your building located at the )ob address stove in accordance with
the conditions and specifications set forth in Bus proposal. Air Conditloning/
Heating System Equipment: 1- Goodman
2ton 14seer Heat Pump outdoor model ft GSZ14024 1- Goodman
2ton AHU with 5kw & Filters indoor model tt ARUF25614A 1- Honeywell
Pro6000 progamable scat. Equipment/System
Warranty: 1-year
warranty on labor, 10-year ltd. warranty on all parts, 10-year ltd. warranty on compressor. Must be
registered by homeowner, otherwise 5-year parts warranty Installation Specifications:
1- All
necessary labor and materials to install the above equipment to the existing duct system. 2. NewairhandlertobereconnectedtotheexistingductsystemwithULlistedfiberboard, fabric tape, mastic foranairtightseal. Air handler to be replaced using 314" plywood decking & sealed. 3. Allaccessibleductworktobeinspectedandanyminorrepairstobecorrectedatnoadditionalchargetothecustomer. Air handler platform to have all damaged insulation repairedireplaced & resealed. 4. Atl
necessary refrigerant & drain piping modifications to install the above equipment- Dralin ra thline
flushed Refrigerant lines
leak tested. evacuated to 500 microns, & charged by sup 5. All
necessary high & low voltage wiring, breaker adjustments, & new whip are included. 6. Outdoor
unit set on vibration isolation pads & fastened to now 4' thick hurricane rated concrete pad. 7. All
necessary safety devices & condensation overflow protection are included. System em
o
be 'installed according to Ste 8. will
be
permitted & of all
job related trash, debris, tandtold equipment provided by Servi e Local codes. One. 9.
100%
Satisfaction Guarantee. price: $4,352 Terms: Net
upon completion. Cash or CC discount -$435 Responsibilities: Net
Total: $3,917 fosponsibilities will
be assumed by each party as indicated. The llowing
re Equipment Foundation
Wiring to
Building Panel Wiring fromDisconnectstoConditioners Wiring of
Control System Cutting Holes
and Patching Redecorating and
Painting Local Permits
and Licenses This proposal
will be cancelled if not accepted by. Purchaser Acceptance:
Se}ler
Approval: Otto Boy Jf 9120120/7
Date -- Date:
812JIV
vine Otto
Boy
Jr. hitps:llmail.
goog le.com/mail/u/0/?ui=2&ik=c9fb335fb4&jsver=RKK5Ah87d4 U .en.&view=pt&search=inbox& th=15e068e73523c82c&siml=15e068e7352.. 3M
A o® CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
08/24/2017
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT Josephine MansurNAME:
Roelnsurancelnc. PHONE (727)376-0030 FAX (727)376-2262CNoExt : A/C NoA/C.
E-MAIL jo@roeins.comADDRESS: 9851 State Road 54
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A: National Builders Insurance Company 16632NewPortRicheyFL34655
INSURED American Builders Insurance Company 11240INSURERS:
INSURER C : Hegeman-Harris Company of Florida, Inc.
INSURER D : dba Hegeman-Harris Co. of Canada
INSURER E822SarnoRd, Unit 3
INSURER FMelbourneFL32935
COVERAGES CERTIFICATE NUMBER: 17-18 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED- NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSRLTR TYPE OF INSURANCE INSD WVD POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000
CLAIMS -MADE OCCUR
DAMAGE To R
PREM SES Ea occu ence 50.000
MED EXP (Any one person) 100,000
PERSONAL& ADV INJURY 1,000,000AGLP02252420109/01/2017 09/01/2018
GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000
X POLICY PRO
LOC PRODUCTS -COMPIOP AGG 2,000,000
Employee Benefits 5,000OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
Ea accident
BODILY INJURY (Per person) ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY (Per accident)
PROPERTY DAMAGE
Per accident
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
UMBRELLA LIAB OCCUR EACH OCCURRENCEHCLAIMS-MADE AGGREGATEEXCESSLIAB
DED RETENTION $
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICER/MEMBEREXCLUDED?
Mandatory In NH)
NIA WCV022523601 09/01/2017 09/O1/2018
PER
STATUTE ERHX1
E.L. EACH ACCIDENT 1,000,000
E.L. DISEASE - EA EMPLOYEE 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
Workers Compensation applies to Florida operations only
GEKTIFIGATE HOLDER GANGELLAI IUN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Sanford Building Dept ACCORDANCE WITH THE POLICY PROVISIONS.
300 N Park Ave
AUTHORIZED REPRESENTATIVE
Sanford FL 32771 jeacsu,l?!1 -v L-mil
1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
CITY OF
SANFORD
FIRE DEPARTMENT
PERMIT NO.
CONTRACT(
JOB ADDRES
TYPE OF WC
Building & Fire Prevention Division
Residential Permit Card
Post this permit in a conspicuous location outside
Approved plans must be posted with permit for inspection
Leave all work uncovered until inspected and approved
Permit expires 6 months from date ofissue or last approved inspection
PROTECT FROM WEATHER
BUILDING
INSPECTION TYPE APPROVED REJECTED INSPEC'70R
ELECTRICAL
INSPECTION TYPE APPROVED REJECTED INSPECTOR
FOOTER INSPECTION ELECTRIC UNDERGROUND
STEMWALL FOOTER/SLAB STEEL BOND
FORMBOARD SURVEY T.U.G. / PRE POWER
SLAB / MONO -SLAB ELECTRIC ROUGH
LINTEL / TIE BEAM ELECTRIC FINAL
SHEATHING - ROOF MECHANICAL
INSPEC77ON TYPE APPROVED REJECTED INSPECTORSHEATHING -WALLS
FRAME MECHANICAL ROUGH
INSULATION ROUGH IN MECHANICAL FINAL
DRYWALL/SHEETROCK PLUMBING
INSPECTION TYPE APPROVED REJECTED INSPECTORLATHINSPECTION
FINAL STUCCO/SIDING UNDERGROUND ROUGH
FIREWALL SCREW TUB SET
FIREWALL FINAL SEWER
INSULATION FINAL PLUMBING FINAL
FINAL SFR GAS INSPECTIONS
INSPECTION TYPE APPROVED REJECTED INSPECTORROOF
INSPECTION TYPE APPROVED REJECTED INSPECTOR GAS UNDERGROUND PIPE
ROOF DRY -IN GAS ROUGH -IN
FINAL ROOF I GAS FINAL
MISCELLANEOUS / FINAL INSPECTIONS
INSPECTION TYPE APPROVED REJECTED INSPECTOR INSPECTION TYPE APPROVED REJECTED INSPECTOR
PRE -DEMO FINAL DOOR
FINAL DEMO FINAL WINDOW
FINAL SOLAR PANELS IRRIGATION FINAL
FINAL POOL SCREEN FINAL SCREEN ROOM
FINAL UTILITY BUILDING FINAL BUILDING (OTHER)
MOBILE HOME TIE -DOWN MOBILE HOME FINAL
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 FBC105.3.3
REVISED: 4-17 Inspection Line: 407.792.6069 or 855.541.2112