128 Hidden Lakes Dr 17-2713 HVAC (2)CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: j,e),- A /3
Documented Construction Value: $ 69W • ---
Job Address: ld 6 AIC1\6fn C*f a • Historic District: Yes NtfijT
Parcel ID: 1 I ' A 501Z - (') 060 -bD.L46 Residentii!f2eCommercial
Type of Work: New Additio Alteration Repair Demo Cliange of Use Move
Description of Work: k4ytaC C oai- c J -,& 3 •J' '1011 51• Ced C.A>44?2 yr-
6 1 51 5— CP E4Z InoY ru'In..Q co
Plan Review Contact Person: Ati-y., Title:
Phone: Fax: Email:
Property Owner Information
Name Phone: CIy7- r'J%
2` Zo y Ly Street:)
PI I,,deC '-, Q ke Or, Resident of property? : _ City,
State Zip: _5Ci'1 fl-( f7L 3_773 Contractor
Information Name
acQ'. e/ C/ i 21 i ci=, gd Phone: Street:
dp e- %lo 4 C Fax: City,
State Zip: 04bl PC 3,2D o I State License No.: em Ah0& 3 Name: Street:
City,
St,
Zip: Bonding Company:
Address: 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 of that date: 51' Edition (2014) Florida Building Code Revised: June
30, 2015 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 ofpermit submittal. A copy of the executed contract is required
in order to calculate ap'lan review charge and will be considered the estimated construction value of the job at the time of submittal.
The actual construction value will befigured 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. OV*
1NER'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. Signature
of Owner/Agent Owmer/
Agent's Name Signature
of Notary -State of Florida . Date Signature
of Contractor/Agent Date D00 / -
ill )1 of
JENNIFER
BOWERS ANY
COMMISS,ON #FF179709 EXPIRES
November 30, 20-18 Owner/
Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me or Produced
ID Type of ID Produced ID Type of ID BELOW
IS FOR OFFICE USE ONLY Permits
Required: Building Electrical Mechanical[] Plumbing Gas C] Roaf Construction
Type: Occupancy Use: Flood Zone: Total
Sq Ft of Bldg: Min, Occupancy Load: of Stories: New
Construction: Electric - # of Amps Plumbing - # of Fixtures Fire
Sprinkler Permit Yes No Q # of Heads Fire Alarm Permit: Yes No Q APPROVALS:
ZONING: UTILITIES: WASTE WATER: ENGINEERING:
FIRE: BUILDING: COMMENTS:
Revised'
June 30, 2015 Permit Application
IE 1 B I FI how® CLIMATE CON !a ROL9 LLQ
Air Conditioning :& Heating
690A E RhodeIsland Ave 11251 Business Park 8vd. Suite 7
Orange City, FL 32763 Jacksonville, F132256
Contract #: Wusa 386-675-6963 Jacksonville+St.Augustine
Orange/Seminole 407-888-0678 904-551-6538 1128brock
Air Conditioning & Heating Ucense#CAC1816634 Email:owner@certifiedclimate.com
Marvin Brock 9/1117 407-342-6246
Proposal Submitted To: Date Telephone H I W
128 Hidden Lake Dr Sanford 32773
Street (Job Location) City 7jp Finail Address
mherebypropose. To furnish,install andmrviceunderwarranty(statedbelow)productsandserviceorrelatedIequipmentforyourhomeorbusinessinaccordancewiththeconditionsandspecifrcationssetforthinthisproposaTonnage3.
5 SEER 15.5 KW 5 PIS N/A Brand Daikin
Single Stage A/CCondencer
A/C Straight Cool Al Air
Handier Gas Furnacevv/ Cased Coil Ql Flood
Switch Aux Closet Pan 0 Condensate
Drainline Flush* 0 Copper
tines Flush Pressure Test* pJ U.
V. ProtectedArmorFlex Lineset Cover V 1/
2" gas line & drip leg V Supply
Duct modify & reconnect Return Duct
Zoning 1
Zones V3 raise
platform as high as we can to grill _ Drywall / Door
Repair Z Platform
Complete Platform / Insulate Yes W Light
16t 0 P1rRIterType&
Si7e24x18 filter back grill p3 Antimicrobial
Spray whole house Duct Seal:
No 0 New
Electrical
to Condenser Disoonnect New Electrical
to AHU Disconnect A/C
Pad &Sze New with Anchor Kit Thermostat Programmable
WiFi NOTES 9
All
work done in accordance with existing codeswith permitting 6 Removal
of existing equipment from the premises V All
work tobe performed ain a neat and professional manner by a trained technician.
SNeeping, dusting and vacuuming will be accomplished and
all debris removed from the premises Customer is
responsible forregisteringequipment with manufacturer with
in 60daysto receive warranties listed below. Minimum of
one preventative maintenanceper calendar year performed by a
licensed contractoris required tomaintain warranty listed below No Maintenance
isincludedin thiscontrad unless itislisted onthiscontrad) All warranties
are limited to the original purchaserunlessauthorized bymanufacturer
ICJ Vtblranty
on Parts 12 years condenser & air handler only Mranty on
Labor 2 years condenser & air handler only Vtkrrartty on
Compressor 12 years Warranty on
Zoning Components N/A WrantV on
Ductwork Florida Public
Utilities ! Rebate: OYeso No $ 500.00 Sub -total: $
6,460.00 Discounts & Rebates: $1,000.00 Discounts sanice
cma $ 0.00 manufactums Reb m $ 0.00 j ccc
Duoa rn $ 500.00 Member Discount $ 0.00 Ar4ea uat
s% $ 0.00 coo otacount 5% $ 0.00 Total Rice (
tax included) $ $ 5 960.00 Terms COD &
Finance $2,500 cod / $3,460 9.9% All Rnandng &
TbrmsareFendng Oast Approvat. Signature (company)
Greg W ' e Signature (customer —'
Date. 9/
1/17 Proposal valid until: Options Requested
Install
We 9/ 1& 17 Certified Climate
Control always recommends replacement of copper lines and drain lineswhen possible. Certified Climate
Control provides no warranty expressed or implied on preexisting copper or drain lines BMR IGHTTO
CANCEL You, the buyer, may cancel thistransaction without penalty anytime prior to midnight of the thirdbusiness day after the date of
this transaction. Seereverse side for terms andconditions
This furnace qualifies for AMACF Federal Energy
Efficiency Tax Credit when placed in service between
February 17 2009 and December 31 2016
AHRI Certified Reference Number: 6647971 Date: 9/5/2017
Product: Residential Furnace Heating Equipment
Model Number: DM80VC0805CN
Manufacturer: DAIKIN MANUFACTURING COMPANY, L.P.
Trade/Brand name: DAIKIN
Series Name:
Rated as follows in accordance with Department of Energy (DOE) furnace test procedures as published in thelatesteditionoftheCodeofFederalRegulations, 10 CFR Part 430 and subject to verification of rating accuracy
by AHRI-sponsored, independent, third party testing:
AFUE: 80.0%
Output Heating Capacity: 64 MBTUH
The following data is for reference only and is not certified by AHRI ;
Input
E }
8`9MBTUH Ef.
77.1 MMBTUIyr Eae
341 kWh/yr 4, r
PEz:
s: 52 Watts =. F;
urnaceType:- Non Weatherizes _ Config
x` Upfloworiz , HontalFuel
Type: Natural Gas,` Pi opane Gas Advanced
Main Air Circulating Fan e"
Electrically Efficient Furnace FootNote
79 - This furnace is equipped with an Electronically Commutated Motor (ECM) Ratings
followed by an asterisk (') indicate a voluntary rerate of previously published data, unless accompanied with a wAS, which indicates an involuntary rerate DISCLAIMER
AHRIdoesnotendorse 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 unauthorizedalterationofdatalistedonthisCertificate. Certified ratings are valid only for models and configurations listed in the directory
at www.ahridIrectory.org. TERMS
AND CONDITIONS ThisCertificateanditscontentsare proprietary products of AHRI. This Certificate shall only be used for individual. personal and %-1-1 X , confidential
reference purposes. The contents of this Certificate may not, in whole or in part. be reproduced; copied; disseminated; enteredintoacomputerdatabase; or otherwise utilized, in any form or manner or by any means, except for the user's individual, AIR-CONDITIONING. HEATING, personal
and confidential reference. & REFRIGERATION INSTITUTE CERTIFICATE
VERIFICATION Theinformationforthemodelcitedon this certificate can be verified at www.ahridirectory.org, click on 'Verify Certificate" link ke liiu bttler- 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. w 131490856770871510 2014
Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.:
sr Mj, ti
A
Product: Year -Round Air -Conditioner, Remote Air -Cooled Condensing Unit
Outdoor Unit Model Number: DX16SA0421A*
Indoor Unit Model Number: CA*F4860*60*+TXV
Furnace Model Number: D*80VC0805C*A*
Manufacturer: DAIKIN MANUFACTURING COMPANY, L.P.
Trade/Brand name: DAIKIN
Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX,
UT, VA, VT, WA, WV, WI, WY, U.S. Territories)
Region Note: Central air conditioners manufactured prior to January 1, 2015, are eligible to beinstalledinallregionsuntilJune30, 2016. Beginning July 1, 2016, central air conditionerscanonlybe .installed.in region (s) for which they meet the reglonal;efficfency requirement
Series name DX1.6SA
Manufacturer responsible for the rating of this system combinations is DAIKIN MANUFACTURING COMPANY,
L.P.
Ratings followed by an asterisk (') indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerale
DISCLAIMERAHRIdoesnot endorse the product(s) listed an 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 theunauthorizedalterationofdatalistedonthisCertificate. Certified ratings are valid only for models and configurations listed In the
directory at www.ahrldirectory.org.
TERMS AND CONDITIONSThisCertificateanditscontents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and. confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; A&
entered Into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual. AIR-CONDITIONING, HEATING,
personal and confidential reference. & REFRIGERATION INSTITUTE
CERTIFICATE VERIFICATIONTheinformationforthemodelcited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link n,i .life lxt er'°
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. 131490858463861;
2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: _.
PERMIT AUTHORIZATION.
I, DAVID HILL hereby authorize
License Holder) (Authorized Person)
To obtain a permit in my behalf under my license # CAC 1816634
To the alC —C)ol Building department for the
Job described below:
PERMIT TYPE DESCRIPTION
HVAC Owner Oro wr-,
Site Address
2 7 r
Tax Parcel #
License Holder Signature)
Date rZ Y-1 /
State of Florida
County Of JdL C. )51 C
Affirmed and subscribed before me on this day of' ,
20/ ^\ by DAVID HILL who is personally known to me.
JODY L MCLEER
MY COMMISSION #FF039242
fFeP ' EXPIRES July 24. 2017
ElaridaNataci ti'F
Pr ype or Stamp ame of Notary
PERMIT NO.
r 44113
CONTRACTOR: Cer * fic at
JOB ADDRESS: / a 8
Building & Fire Prevention Division
Residential Permit Card
ISSUE DATE:
lh'dafeti (w ok
c d
TYPE OF WORK: C/4D JW#4 eaWr
q 4P 144 47
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 of issue or last approved inspection
PROTECT FROM WEATHER
BUILDING
INSPECTION TYPE APPROVED REJECTED INSPECTOR
ELECTRICAL
INSPECTION 7YPE APPROVED REJECTED INSPPEC70R
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
INSPECTION TYPE APPROVED REJECTED INSPECTORSHEATHING - WALLS
FRAME MECHANICAL ROUGH
INSULATION ROUGH IN MECHANICAL FINAL 4
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 7YPE APPROVED REJECTED INSPECTOR GAS UNDERGROUND PIPE
ROOF DRY -IN GAS ROUGH -IN
FINAL ROOF GAS FINAL
MISCELLANEOUS / FINAL INSPECTIONS
IIVS'PEC77ON 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 FBC 105.3.3
REVISED: 4-17 Inspection Line: 407.792.6069 or 855.541.2112