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HomeMy WebLinkAboutBLDG PERMIT #12564 Date,.[ D CITY OF CAPE CANAVERAL Tracking# 1�,---OSo9y- AUG 27 2015 BUILDING PERMIT APPLICATION Permit# / X5C f (321)868-1222 Y-f • •<-/I 31a6 (C. City of Cape Canaveral Building Department-P.O. Box 326— 110 Polk Ave.-Cape Canaveral,FL 32920 You may download this application: www.cityofcapecanaveral.org. You may fax to: (321)868-1247. All applications must include the backside of this form & 2 sets of supporting documents. Important: Please complete the checklist on the back of this form and provide other documentation as indicated on the checklist. A copy of the contract may be required. Application packages will not be accepted unless complete. APPLICANT WILL BE CALLED WHEN PERMIT IS READY (Contractor/Owner-Build is require to sign for the building permit,unless indicated otherwise by affidavit. I.D.may be required) Address of Job Site: 17_I l V \tjç Zoning classification: Flood Zone: X Legal description of pro t- : TWN: 7,4 ,RNG: 3-1. SEC: L 9 SUBD: BLK: LOT:qt.e PB: t PG: 7 Z. Property OwnerName: ' ■ _6 _ Phone: Address: (-kw kabar (c.cecOL1 AFee Simple Titleholder's Name Address: Bonding Company: 1( , k Address: Mortgage Lender: 14 Address: 4 Type of Permit Brief description of work: f Building L�in1�. \cly,\\•1 Qe-5caer,ce _ Electrical Plumbing Mechanical Other Type of Square Const. Occu- FPL lines City Sewer #of #of #of #of #of-- )' BuildingFeet Type pancy currently available Concrete! stories dwel- bed- water Valuation of work under (IA, Classifies available to to serve Asphalt ling rooms closets icoP'of Contract Required) 'please roof VB, -tion serve this this Parking units udicatcas etc) (B,RI,R3 property? property? Spaces applicable) etc.) Yes/No Yes/No . _ Commercial `` .-fi S , SFR 3_0(4. , `ICS 1 I S Townhouse S Apartment $ Condominium S Other S Architect/Engineer Name: • • ` Name of Company: . G • - • 10_ Address: i 6 _ • .•. vow .. • • • State License No.: b�: Phone(office): Phone(cell/pager.): IMI �:-'. .:.Fax: Primary Contractor Name: ' •• ' - . _•` Name of Company: ‘ a „.• ` ._a . _. Address: Lk)(40 Qf KS‘-.it-e_ is .%e bous"- ri pL' State License No.: Phone(office): Phone(cell/pager.) 3 Lil? i -�t l5Fax: Electrical Contracto Name: ♦ • f. Name of Commany: :_ T t :a. I • Address: 11(-J4 t\- '‘ liC\Ofl ia c Fl 3 2 g e State License No.: $6 • $ Phone(office): Phone(cell/pager.): Fax: Plumbing Contractor Name: _., • t;ll • Name of Company: •a, • slam • - 1► ti' . . . Address: . • • %• Atrialafflnlo O. . • - State License No.: 4:11t Phone(office): . al `a; Phone(cell/pager.): Fax: Mechanical Contra •r Name: • - .• 66 A.a •.1 • Name of Company'.'kk ,• ., - •a•. •.a • Address:5?.•li *�/A:. \ ` • • • State License No.:Wes Phone(office): Phone(cell/pager.):MV ' 'RATe Fax: Specialty/Other Contractor Name: _ N Name of Company: Address: I State License No.: Phone(office): Phone(cell/pager.): Fax: • C7'B1dg.Dept.Fo ms\Building Permit Application Revised 6/29;15 4 Building Permit Application Checklist Notes Completed Permit Application Current code edition:FL Bldg.Code 2010(as revised) Current survey showing all proposed construction and landscaping Check with Bldg.Dept.for setbacks XNotarized signature—Owner/Builder Affidavit If owner is acting as contractor Sewer Impact Fee receipt May be deferred until C.O.Unless job is remodeling County Impact Fee receipt May be deferred until C.O. Capital Expansion Impact Fee receipt Maybe deferred until C.O. Sidewalk Impact Fee receipt If sidewalk exists on lot - Recorded Warranty Deed/Proof of Ownership Copy of Recorded Notice of Commencement(over$2,500) Over$7,500 for Mechanical change out Current Cert.Of Liability Ins./Worker's Comp.Policy/Exemption Record will be kept on file after initial submittal Community Appearance Board Approval For all work visible from Public Right-Of-Way Planning and Zoning Board Site Plan Approval For all new construction of four units or more Concurrency Forms For all new construction not part of approved site plan Primary Contractor's State License Record will be kept on tile after initial submittal Subcontractor's Authorizations: Record will be kept on file after initial submittal State License Notify Building Department of contractor changes Plumbing Contractor Plumbing Contractor Electrical Contractor Electrical Contractor Mechanical Contractor Mechanical Contractor Roofmg Contractor Roofing Contractor Swimming Pool Contractor Swimming Pool Contractor Gas Contractor Gas Contractor Specialty/Other Contractor Specialty/Other Contractor Construction Drawings: Per F.B.C. 104 Three sets of sealed construction drawings Per F.B.C. 104 Truss layout and reaction summary Cut sheets and shop drawings will be needed at time of insp. 1 Electrical Load Calculations Plans must indicate person responsible for calculations I1 — Electrical Riser All new service must be located underground Plumbing Riser _ Plans must indicate person responsible for design A/C layout Plans must indicate person responsible for design Two sets of Energy Calculations Plans must indicate person responsible for calculations Lot Drainage Survey Four sets of Fire Suppression/Sprinider/Alarm specifications Requires Fire Dept.approval prior to issuance of permit Pool Barrier Requirement Form(signed) Pool permits will not be issued without barrier • 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 the standards of all laws regulating construction in this jurisdiction. The Building Code in effect at the time of this application is the Florida Building Code 5th Edition. I understand that all permits require inspections as indicated and that it is the responsibility of the permit holder to notify the building department when ready for inspection(s). This permit application is valid for 180 days from date of submission. By signing, applicant affirms that all above is true and correct and that he/she is an authorized agent of the Contractor/Owner and has the authority to apply for this permit. *ALL OTHER APPLICABLE STATE OR FEDERAL PERMITS MUST BE OBTAINED 0 T OMMENCEMENT* • Contractor's Name: C',cxc (Jç e 5 S OC\N Contractor's Signature: Date: El -Zo - 15, Site Address: 1 ZI Oo \cr . 4 . For Notary use only: State of Flori4a,Aunty of B yard • Sworn and subscribed before me this ` day of U licant produced identification: or is personally kno "•`. .0,4:., BRANDY DENISE TORRES MY COMMISSION#FF084703 Seal: %«t, '. EXPIRES January 21.2018 ,07)398-0153 FloridaNatary Sew ice.cotnature-Notary Public At Large G:\BIdg.Dept.Fonns\Building Permit Application Revised 6/29/I5 This form may be duplicated. i 1 r...,"..... I I I I i I I I I I I ' 'J l Architect/Engineer Name: _ 6 6 G . • -- 1- Name of Company-- - . C- • _ AVIS 10 Address: I b _ ,. s .. (ai�iii i�• - • • State License No.: ! T Phone(office): - Phone(cell/pager.): ,i 0:- ,.Fax: it Primary Contractor Name: s Name of Company: 1 Yn Address: z 40 (S. KSI 'rL -iC.1e , 2 hoUftle_. F! L�C'c�r��rUC1i State License No.: Phone(office): Phone(cell/pager.)�3 IRAIE.?-6,H(15Fax: Electrical Con cto ame: a k 1 k - II. Name of Com.any: % T g ;s. „ Address:116H „M t k c IYAr(1 i s • Fl 3?q Q State License No.: G G • $ Phone(office): Phone(cell/pager.): - . - / Fax: Plumbing Contractor Name: ! . Ai, ' 1&VI) ' Name ofCompany: 141. s, a 41,v , - li 11 Address: L%% LI t 2 � 2-(*Cx2yt- 'Rn34 \ / State License No.: ♦ IPhone offce): 3hone(cell/pager.): Mechanical Contra .r Name: 4 - .I1 6 fa ' a 4_i .- Name of Company. • . `,6 4,% - I' will. ,'11.a' ,4I1 Address: :II •.%. . k 111 t • a '' : L I r State License No.: ' 6 Phone(office): Phone(cell/pager.): �■�lli 'Eli��S Fax: Specialty/Other Contractor Name: f K Name of Company: Address: State License No.: Phone(office): Phone(cell/pager.): Fax: t, BIile.Dapt.Fonns building P.timit Application i:,•r:� y_o i NOTICE OF COMMENCEMENT PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA COUNTY OF BREVARD THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement. 1. Description of property:Xegal desc • tion of the property and street address if available) L - - L 1Z1 OC\Y‘ \Oe. Q.CAOC- CQ I c1 • l c� 1 t. 1, 2. General description ofimprove�tent: x t>p' 'F' I2�� - nCe, 3. Owner information:a)Name and address: • lb. A eb, 1,• b - • eat . b)Interest in property: • c)Name and address of fee simple titleholder(if other than owner): N I l\ 4. Con for(Name and address 6.• Zb1/4-10 c Y.' ce. %c CSC' ,ocr‘e . rt lt dit 5. Surety: N i k a) Name and address: . b) Amount of bond: 6. Lender(Name and address): 1.1 ' A 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13 (1)(a)(7).,Florida Statutes(Name and address): 8. In addition to himself,Owner designates of to receive a copy of the Lienor Notice as provided in Section 713.13 (1)(b),Florida Statutes. 9. Expiration of date of notice on commencement(the expiration date is 1 year from the date of recording unless a different date is specified): . k WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,SECTION 713.13,FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF C••• NCEMENT MU:- BE ORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OB • t FIN: C I G,CON YOUR LENDER 446rr OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR N a TI OF CO i1 . ' / ...„ \ - CFN 2015166008,OR BK 7435 PAGE 306. Signature of07.er or Owner's Authorized Recorded 08/20/2015 at 02:16 PM,Scott Ellis,Clerk of Courts, Officer/Director/Partner/manager Brevard County ti Pgs1 g (2),ti T Signatory's Title/Office STATE OF FLORIDA COUNTY OF BREVARD /n�� The foregoing instrument was acknowledged before me this&day of "Jo/y ,20P'by T�7,�iGC �� (name of person)as CthAla. PR0:. (type of authority eg:officer,tru ee,attorney in fact)for 9' �'gt A- V-_,c-- (name of party on behalf of whom instrument was executed) r „. MICHELLE MCMICHAEL Signature of Notary r Public•Slate of FloridaPrint,Type or Stamp Commissioned Name of Notary Public yrMy Comm.!spina Nov 2,2018 Commission Number Yes ” Commission I FF 187051 '..It Bondedth°uphNatimslNotary Assn Personally Known V or Produced Identification Verification Pure,ant to S ction 9 S F1or, a S a Stec , / Ilpir Under penalties of perjury,I declare that I have read the foregoing and that the facts stated in it are true to the best of.. ...• r Signature of Natural Person rgning"•e BUILDING PERMIT FEES Address: f 27 OAK C tJg Srez. CONSTRUCTION TYPE SQ. FT. COST *MODIFIER VALUE 1&2 FAM. CONDITIONED: 7-c-27-4‘,..: 3 00c 47/245' .91 $ 30g, 457 1&2 FAM. UNCONDITIONED: .91 $ OTHER: .91 $ OTHER: .91 $ OTHER: .91 $ `/ TOTAL CONSTRUCTION VALUE BASED ON ICC VALUATION CHART $ 50g, 4.57 TOTAL CONSTRUCTION VALUE BASED ON CONTRACTOR ESTIMATE: $ 3013',057 _cook 208;451 = 54,5 zo9 xSli : + 83(0 BUILDING PERMIT FEE: $ \ )LA 01 -- 4 1 ii-{o l GROSS SQUARE FOOTAGE: 3 0O0) BUILDING PLAN REVIEW FEE: (1/2 THE BUILDING PERMIT FEE) $ 700.Sb l.r? ELECTRICAL: $ /e9 o 6' M Ni PLUMBING: ( 2) x Go $ 120 MECHANICAL: $ 7.5' FIRE DEPT. PLAN REVIEW FEE: $ / BUILDING PERMIT SURCHARGE: (GREATER OF$4.00 OR 3% OF TOTAL FEE) $ 71.c)0 CONCURRENCY MANAGEMENT FEE: $ /00 TOTAL FEE DUE: $ 25478.4/0 Calculated By: Date: 9'2 '15 Modifier is a regional cost modifier set by the International Code Council w Date: q-Z$-(5 CITY OF CAPE CANAVERAL Capital Expansion Trust Fund Impact Fees & Sewer Impact Fees Project Name: S F' Permit Number: TZtic12-trs G [' -e'A 0 q- Property Owner: S ti g m P At LL- Address of Job Site: t 2.1 oho.)E CONSTRUCTION CLASSIFICATION: Residential: Non-Residential: Calculation of Capital Expansion Impact Fees (fund 302) (Prepared by the Building Department) PARKS &RECREATION: $ 5 l 55 LIBRARY: $ .D5 GENERAL GOVERNMENT $ ( o 5 •71 POLICE $ E Zg ,2') FIRE/RESCUE $ 4. 39 AERIAL FIRE TRUCK $ —� TOTAL CAPITAL EXPANSION IMPACT FEES $ S 3 ,91 Calculation of Sewer Impact Fees (fund 401) (Prepared by the Building Department) SEWER IMPACT-RESIDENTIAL $ 1 , 34 g • $a SEWER IMPACT-COMMERCIAL $ SEWER TAP FEE Do TOTAL SEWER IMPACT FEES $ I ‘-J 13 • gO T©tkL \c )\-3 .--i Turnkey Construction 2640 Brookshire Circle Melbourne FL 32904 (321 )403-3263 please email back to Brandytorres81@yahoo.com Thank you! c3J fl I (5 u;\Pc° C.t ) 2,; DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION • .—/ ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 4:44: 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 PENNELLA, JOHN M JR BEST ELECTRIC OF PALM BAY, INC. 1364 MIT COURT NW PALM BAY FL 32907 Congratulations! With this license you become one of the nearly - _. •---_-- one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range �• STATE OF FLORIDA from architects to yacht brokers, from boxers to barbeque restaurants, 3 DEPARTMENT OF BUSINESS AND and they keep Florida's economy strong. PROFESSIONAL REGULATION Every day we work to improve the way we do business in order to EC13006170 ISSUED: 07/14/2014 serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information CERTIFIED ELECTRICAL CONTRACTOR about our divisions and the regulations that impact you, subscribe PENNELLA,JOHN M JR to department newsletters and learn more about the Department's BEST ELECTRIC OF PALM BAY, !NC. initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, IS CERTIFIED under the provisions of Ch.489 FS. and congratulations on your new license! Expiration date AUG 31,2016 L1407140000209 DETACH HERE RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD ry LICENSE NUMBER "' EC13006170 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 PENNELLA, JOHN M JR • + r BEST ELECTRIC OF PALM BAY, INC. • 1364 MIT COURT L NW PALM BAY FL 32907 4 � n = 2014 BREVARD COUNTY BUSINESS TAX RECEIPT ACCOUNT NO. 215 THE PERSON(S),OR ENTRY BELOW: SUBJECT TO COUNTY ZONING RESTRICTIONS 885001372 TAX RECEIPT SHOULD BE DISPLAYED ON PREMISES OCTOBER 1,2014 - SEPTEMBER 30,2015 BUSINESS PERIOD: EXPIRES: SEPTEMBER 30,201,5 DOUG HAMBEL'S PLUMBING INC ISSUED PURSUANT AND SUBJECT TO FLORIDA STATUTES AND BREVARD COUNTY CODE ISSUANCE 4190 DOW RD DOES NOT CERTIFY COMPLIANCE WITH ZON143 OR OTHER LAWS. MELBOURNE FL 32934 BUSINESS TAX RECEIPT IS SUBJECTTO REVOC471ON FOR ZONING VIOLATIONS,AND I OR FAILURE • TO MAINTAIN REGULATORY PRE•REQUSITES AS REQUIRED FOR BUSINESS CLASSIFICATION(S),OR SUBSEQUENT ACTIVITIES. NOTIFY TAX COLLECTOR UPON CLOSING OF BUSINESS. A PERMIT IS REQUIRED TO ADVERSE(Inducting with slgnage)'GOING OUT OF BUSINESS'. LISA CULLEN,CFC,Brevard County Tax Collector LOCATION: P 0 Box 2500,Titusville,Florida 32781-2500 4190 DOW RD (321)264-6910 UNINCORP DIST.5,FL 32934 UPON A CHANGE OF OWNERSHIP OR LOCATION, . BUSINESS TAX RECEIPT SHOULD BE TRANSFERRED WITHIN 30 DAYS. OWNED BY: PROF. LICENSE REQUIRED DOUG HAMBEL'S PLUMBING INC DOUG HAMBEL CFC057818 BUSINESS CLASSIFICATIONS,DISCLAIMERS,AND RELATED FEES:• .. •- _ _ . .EXEMPTIONS: NON EXEMPT PENALTY: 5.00 300480 PLUMBING CONTRACTOR 820005 2014-2015 RECEIPT AMT $37.00 I, . 1/0%,e,21::rlt \\\\ /tee illi V•'''!i:ii'.1142+ ,r i, .. ,.t.,P,_,-.4 OA' PAID It' kV ririt i' 0 e e�Pl' tf04 31470 �` '_4 ' . W .' ow. �,iiF�k{, , 1' ,, £ Lam' M1 ` c �,A.. ; \\,,,,.....k:44--,,. -......,,..„sp.,-;„0„.„,,, :,.,,:s.,- 4! rte./ . BRANCH OFFICES: Merritt Island Office,1450 N.Courtenay Pkwy,Merritt Island,FL 32953 Melbourne Office,1515 Samo Road,Melbourne,FL 32935 Palm Bay Office,450 Cogan Dr.SE,Palm Bay,FL 32909 MAIN OFFICE: 400 South St„6th Floor,Titusville,FL 32780 (321)264-6910, (321)633-2199,ext.46910 1 BTA•TXIRCPT--04 I °'11 ,i', STATE OF FLORIDA , „,,tsl,•DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION 0, CONSTRUCTION INDUSTRY LICENSING BOARD • (850)487-1395 -t 1,w- 1940 NORTH MONROE STREET. TALLAHASSEE FL 32399-0783 HAM BEL, DOUGLAS WILLIAM DOUG HAMBEL'S PLUMBING INC 4190 DOW ROAD MELBOURNE FL 32934 Congratulations! With this license you become one of the nearly R'`' ' m'i'g' �'zamv"0 aniz- °�`t smiiiiiik one million Floridians licensed by the Department of Business and - - _ Profetsional.RegAlation. Our professionals and businesses range i •STATE.OF,FLORID'A7 • . ,, , • - DEPART 1..it.,;.s BIJ.SINSS.S_Ar .. . from architeptsxayzcbf.bookers fianlzozc�ers_tobar_�aque_resteu[a_nfs;... ,. ._ and they keep Florida's economy strong. •°, . ` PROF.- (6.1 ''t�+ ;.ULATION Every day we work to Improve the way we do business in order to 1357818 ,iL " •07/31/2014. serve you better. For Information about our services,please log ontoi a' h www.myflorldalloense.com. There you can find more information TIFp p < h+Y card r. U ' .,;.. about our divisions and the regulations that impact you,subscribe >,i r-.M> I .E-�p 1tglA er g �,.r. - • :-' to department newsletters and learn more about the Departments 7 .. � ,s B :"42.`'1,1'r'' t , P. ., 1•__;'•' _'..,~ initiatives. -, .::.-•- e ,;: •-i.:.-1?.'/--' - -• • .•-';;• _��,,r a: •_..-. Our mission at the Department is:License Efficiently,Regulate Fairly. !,F°�'"."�"�-: ‘ti �. ,ii+ ,s • •r" ^' - -.�� We constantly strive to serve you better so that you can serve your ! -.•^-,-- - . customers. Thank you for doing business in Florida, z �9• r "'� •r-c3R4,aa-i~s.- and congratulations on your new license! '"Drer -• O0D196'" '' • DETACH HERE RICK SCOTT,GOVERNOR LAWSON,SECRETARY - .- . _ . _ .... 1 I .. • -• STATE OF FLORIDA • i DEPARTMENT OF BUST 88 AND PROFESSIONAL REGULATION f; , ' ' :%l; • DEPARTMENT P'A. DUBTRY LICENSING BOARD • • i C. _LIC[NSE NUMBER . • .+ • • • • •TFa6,PliJNI8ING.C:4N ACTQ ..., - -.' � _ ��. .'• •..;. . , 'Napt di elorit'S IFIEU- '•,-r.. .._ • rs . • '�.., .1. .: • -.,�, � %J . ,`1 i ,)leder fher�rov ian of~ .>E /yp�tQer•489�.Sr w ": �`-�- -•.'+• :`'' - .. it i •d tog 1 ... , `.`..••';•,'�.,....,.. \-„\'..,:•....:..•• �� p gp ..- r' - ^, w�.•,•.—• "-.,,,.• ..., 5:,.,. + „',,+.` �•- '..\-•,:.;',,,...:,%,,N,+* a• •.�,+ �,,.,•_.---s . .,.,; - ID -71..-0-P. � - _e. •\\ .3 1''PO.k1t_ A VC�1$E ...:: _01...,„.,....::„.v aar ,. > , :> u '-‘ft-4.'.1:7:4..-In!, ,.,,, . �.� '4. ,ID'S/,\l'R s •D -"'.*sr'' " ". �* a„` x -4.'.7 4.i v' t'' '+\.. ..4;: 'i r'''').::::" 70 • • //�,.,•"'„,13: :::--:":;:ivii1:07:: ef,AVE'* -61?,;1.r4••••••• ',A3/4,,,,'r-•d''^7f e0., ''jtYY4.e vl ry i ''a ♦ , ,t''�r�.G �..^- n _.... f� "u'., _ ...:1.....7. 3.,.:,1 '"1,,' 1•ti .1 h, ,,.'�. , �, ,,,,,,v,..,„_. :9 .....\._,% \ �, ,.,1,,,‘. ...\\ .,1 \•'.,.t1�f t',. 2.,..s, ... u•wscn. 11.7/04 P1114 A IIICDI AV AC I CII IIDCf RV I ANA/ CRA if 11A(17Z4nAnl744 ACORO® DATE(MMIDD/YYYY) ‘4....----- CERTIFICATE OF LIABILITY INSURANCE 4/9/2015 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(les)must 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 Pam Watson NAME: Brown & Brown of Brevard (A/c. : I(321)757-8686 INAXC NA:(321)757-8687 7341 Office Park Place AE-MAILDDRSs:pwateonebbbrevard.com Suite 202A INSURER(S)AFFORDING COVERAGE NAIC e Melbourne FL 32940 INsURERA:Westfield Insurance Company INSURED INSURER I3:PFVA Mutual Insurance Company 10385 Doug Harnbel's Plumbing, Inc. INSURERC: 4190 Dow Road INSURER0: INSURER E: Melbourne FL 32934 INSURER F: COVERAGES CERTIFICATE NUMBER:CL154914657 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. INSR ADM OF INSURANCE ADSBR POLICY EFF POLICY-EXP LTR INSD MND POLICY NUMBER IMM/DDIYYYYI (MWDO/YYYY), Wert COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAMS-MADE __J OCCUR PREMISESIE&ocanence) S MED EXP(Any one person) S — PERSONAL&ADV INJURY_ S GERI AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POUCY JECT LOC PRODUCTS-COMP/OP AGO S OTHER: S AUTOMOBILELIABILITY COMBINED SINGLE UMIT $ 1,000,000 (Ea occident) A ANY AUTO BODILY INJURY(Per person) S AOSCHEDULED AUTOS CW1.1312791 4/12/2015 4/12/2016 BODILY INJURY(Per accident) S X AUTOS NON-OWNED WbPERTY DAMAGE f HIRED AUTOS AUTOS (PeracdWMl X • Undetinsuredmotorist S 500,000 UMBRELLA UAB OCCUR EACH OCCURRENCE S EXCESS UAB H CLAIMS MADE AGGREGATE S - DED RETENTIONSp�}�. S WORKERS COMPENSATION ER AND EMPLOYERS'LIABILITY Y/N STATUTE ANY PROPRIETOR/PARTNER/EXECUTIVENIA B EL EACH ACCIDENT S 1,000,000 OFFlaR/MEM EXCLUDED? y WC840-00303.42-2015A 1/11/2015 1/11/2016 EL DISEASE-EA EMPLOYEE S 1,000 000 (Mandatory NH) atory in NH) , If yea dssaibe utMw DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Cape Canaveral THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 7510 N Atlantic Ave Cape Canaveral, FL 32920 AUTHORIZED REPRESENTATIVE Mark Cobb/PAM C. C— ---1- ---- 01988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD I NS025 M14011 DOUGHAM-02 MVANDERLEE AC-ORO' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 4/9/2015 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 pollcy(les)must 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 License#L087297TACT Hub International Southeast PHONE Eaet:(321)265-2220 ac ): 3760 N.Wickham Road ( ,No Suite 2 S: Melbourne,FL 32935 INSURER(S)AFFORDING COVERAGE NAIC f INSURER A:Cincinnati Insurance Company 10677 INSURED INSURER B Doug Hambels Plumbing Inc INSURER C: 4190 Dow Rd. INSURER D Melbourne,FL 32934 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR TYPE OF INSURANCE ADOL SUBR POLICY EFF POLICY EXP' WATTS LTR INSR WVD POLICY NUMBER IMMIDDIYYYYI (MMIOOIMYYY1 A X COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE OCCUR CAP6239266 04/12/2015 04/12/2016 pDR MISE$ERe NoCpltfDDC6) = 500,000 X Emp Ben.1mm/1 mm MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE UNIT APPLIES PER GENERAL AGGREGATE S 2,000,000 POLICY n JEta n LOC PRODUCTS-COMPAP AGO S 2,000,000 _ OTHER _ S AUTOMOBILE LIABILITY COMBINED SINGLE UMIT S (Ea accident) ANY AUTO BODILY INJURY(Per person) S — ALLOIMED SCHEDULED BODILY INJURY(Per accident) S — AUTOS -_AUTOSNON-OWNED PROPERTY DAMAGE S _ HIRED AUTOS _AUTOS (PIKoccident) X UMBRELLA UAB r OCCUR EACH OCCURRENCE S 1,000,000 A EXCESS LIAR CLAIMS-MADE CAP6239265 04/12/2015 04/1212018 AGGREGATE S _ DED RETENTIONS Aggregatep�' S 1,000,000 WORKERS COMPENSATION PERATUTE I R' AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y�N/A EL EACH ACCIDENT S OFFICERIMEMBER EXCLUDED? ' (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S If yea deealbe under DESGrRIPTION OF OPERATIONS below E.L DISEASE-POUCY LIMIT S DESCRIPTION OF OPERATIONS(LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If mon space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof CapeCanaveral THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 7510 N Atlantic Ave Cape Canaveral,FL 32920 AjUU[,HJ/��ORIIIZZED REPRESENTATIVE(� f� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD S.e Re✓used- Wt.,' a5 SA A,,,vo 44:12 7-z3-iS in y` �` City of Cape Canaveral �br , - =' ''��—� Community & Economic Development CITY o, CARE CANAVERAL PLAN REVIEW CORRECTION SHEET Date of Review: 9-16-2015 Applicant Name: Turnkey Construction '{ Project Name: Single Family Residence Phone Number: (321)-288-6415 Project Address: 127 Oak Lane E-mail: Brandytorres81@yahoo.com The following items were noted on your submittal as areas requiring correction and/or clarification. Please address each comment by its corresponding number. You may fax replies to(321) 868-1247. If you have any questions about this plan review please call (321) 868-1222 and ask to speak with the Plans Examiner or Building Official. Please amend all copies of the previous submittal to reflect any necessary revisions and re-submit to the building department. This re-submittal will be reviewed by the Plans Examiner and will result in either a permit or an additional plan review comment sheet. Your application will remain on file for six months from the date of submittal. Please provide the following additional information: 1. Provide Engineer sealed clarification letter or revised sheet,that design meets current 2014 FBC 5'h Edition and 2011 NEC.One conflict in drawing data; Project Data Summary on drawing sheet 2 states older codes. 2. Design pressure for OH Doors on drawing sheet 2,minimum required pressure for / 150mph Exposure C is+24.6/-27.3 psf. Drawing was marked to note this. �/ Submitted OH Door data of+30/-30psf is good and meets FBC.No action required on this item. 3. Engineer to clarify how many places this larger footing detail applies? "Typ Porch Block Column Pad"detail"ftg.8". 4. Engineer to clarify NEW FRONT PORCH DETAIL on drawing page 4.Note calls - / for triple 2 x 12 wd beam,contrary to note on drawing page 1. ✓ 5. Clarify ceiling insulation proposed, R-30 is called for in energy efficiency data. Drawing states R-19 minimum. 6. Provide approved and signed Concurrency documents. .4---, ?C01-) °l -25-15 Joe Maciejko,Building Plans Examiner Cc: Mike German,Building Official 110 Polk Avenue-P.O. Box 326-Cape Canaveral, FL 32920-0326 Telephone(321) 868-1222-Fax (321) 868-1247 www.cityofcapecanaveral.org e-mail: info@cityofcapecanaveral.org