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HomeMy WebLinkAboutContractor Info. BP#11440 135 CicAY Lene_, Plumbing Contractors Paper work Douglas Hambel .40p. CITY OF CAPE CANAVERAL pry' j —L. - AUTHORIZATION FORM City of Cape Canaveral Building Department 7510 N.Atlantic Ave. Cape Canaveral,FL 32920 (321) 868-1222 (You may download this authorization: www,cityofcapecanaveral.org. You may fax to:(321)868-1247. Date: 2- \ 1 ' q Permit it: CONTRACTORS AND SUBCONTRACTORS -PLEASE HAVE YOUR SIGNATURE NOTARIZED AND SUBMIT HIS FORM WI PERMIT``__ APPLICATION. Company Name: 1 ,CX���` UMi] (5 B g c s \-`ocrr�oe_1 ,hereby authorize C.1,e\d 3,e.sSoclt, I, (State icense Holder's Name—PLEASE PRINT) (Authoraed Person—PLEASE PRINT) to obtain a permit on my behalf under my state license(s) as issued by the Department of Q Business and Professional Regulation,Construction Industry Licensing Board �cW74 81 O, (State License Number(s)} for the job site described below. An authorization will be r aired for each permit Type of Permit `,�ccLL(1 Building Name ot Property Owner Plumbing 115 (x LOCNe__, Electrical Address of Job Site Mechanical Roofing 41 ,I fp44 t , Swimming Pool Si`nature of License Holder Specialty Structure Other—Specify: For Notary use only: State of Florida,County of Brevard Sworn and subscribed before mc this day of� 1t.tlo r 1 ,20\‘.1/4 ,by /. N of Applicant F:- who produced identification: or . is personally known to me. Seal: . ilet 1:/'-r .r,- -nature-Notary Public At Large G:tsldg.DeptFoans•'\Authorization Form This form may be duplicated_ b'd 9£6£65b6Z£ uoi;onJlsuoO (e)(wnl ACORD CERTIFICATE OF LIABILITY INSURANCE DATE 013 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 (AMNo.Exit Nuc,FAX Noe(321)757-869? 7341 Office Park Place EMAIL ADDRESS: Suite 202A NSURER4S)AFFORDING COVERAGE NAM II Melbourne FL 32940 (NauRERA:Old Dominion Insurance Co INSURED NSURERB:FFVA Mutual Insurance Company 10385 Doug Hambel'a Plumbing, Inc. INSURER C: 4190 Dow Road INSVRERD: INSURER E: Melbourne FL 32934 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1311712076 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 ADOL(SUS}t POUC}/EFF POLICY EXP LTR TYPE OF INSURANCE INSFO NND POLICY NUMBER 04M/601YYYY) IMMIDOA'YYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE S —'COMMERCIAL GENERAL LIABILITY DAMAGE (EaENTED ocaxrence) S I CUUMS-MADE [J OCCUR MED EXP(Any one person) S PERSONAL&ADV INJURY S , GENERAL AGGREGATE S GENT.AGGREGATE UNIT APPLIES PER: PRODUCTS-GOMP/OP AGG 5 7 POLICY E IF'M l l LOC S AUTOMOBILE LIABIUTY COMBINED SINGLE UMIT (Es occident) S 1,000,000 ANY AUTO BODILY INJURY(Per person) S A " ALL OWNED —"SCHEDULED B1G5642H 4/12/2013 4/12/2014 BODILY INJURY(Per acclderd) S AUTOS X DAUTOS X NON•ONPIEO MS PROPERTY DAMAGE S _AUTOS (PeraccIden)1 X Undednsuredmo!odst S 500,000 UMBRELLA LIAB -_OCCUR EACH OCCURRENCE -S EXCESS LIAR CLAIMS-MADE AGGREGATE S DED I RETENTIONS $ g WORKERSCOMPENSATION I WRY]CSTATU- 10T - Y AND EMPLOYERS'LIABILITY IN TO [MITE PR ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A FYC840-0030142-20147+ 1/11/2014 1/11/2015 (Mandatory In NH) E.L DISEASE•EA EMPLOYEES 1,000,000 ((yes,deWiSe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY UNIT S 1,000,000 DESCRIPTOR OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Addlttonel Remad,a Schedule,If more space le required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Cape Canaveral ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 7510 N Atlantic Ave Al1TTNORIZEDREPRESFNTATNE Cape Canaveral, FL 32920 Mark Cobb/PAM < lino ACORD 25(2010105) ©1988-2010 ACORD CORPORATION.All rights reserved. INS025 r,ntnncx m Th a(:ARf nem,.enA Irvin aro ranlcfarad me roc nF Ar.flon AO RD® CERTIFICATE OF LIABILITY INSURANCE 4/11/2013D ) 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 POUCIES 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 Sandi Gleason NAME: Lassiter-Ware Insurance of Maitland PHxo ONE (800)845-8437 inic,Noi:(888)883-8680 2701 Maitland Center Parkway ADDESS;sandig@lassiter-ware.com Suite 125 INSURER(s)AFFORDING COVERAGE NAICI Maitland FL 32751 INsuREaA:Southern Owners Insurance Co. 10190 INSURED wsuaERaBridgefield Employers Ins Co 10701 Doug Hambel's Plumbing, Inc INSURER C: 4190 Dow Rd. INSURERO: INSURER E: Melbourne FL 32934-9212 INSURERF: COVERAGES CERTIFICATE NUMBER:13/14 Master REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTIMTHSTANDING 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. MISR ADD.SUER _POLICY EFF POLICY EXP LIR TYPE OF INSURANCE INSR WVD POLICY NUMBER IMMIDDIYYYYI IMMIPDIYYYYI LIMITS -LIABRITY EACH OCCURRENCE . S_ . 1 080 000 GENERAL X COMMERCIAL GENERAL LABILITY PREMISES(Ea mammal 1 s 300,000 A CLAIMS-MADE [OCCUR X X 7273794713 4/12/2013 4/12/2014 ling Exp(Any one pence) $ 10,000 — PERSONAL 8 ADV INJURY S 1,000,000 — GENERAL AGGREGATE s 2,000,000 GEM.AGGREGATE LAIITAPPUES PER: PRODUCTS•COMP/OP AGO $ 2,000,000 7 POLICY' i 17 I LOC S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) 3 — ANY AUTO BODILY INJURY(Per Pawl) $ —BOOS NEO SCHEDULED BODILY INJURY(Per aaide80 $ FIRED AUTOS — NOfFEO PROPERTY DAMAGE S _ AUTOS (Peracddenll — s X UMBRELLA LAB X OCCUR EACH OCCURRENCE S 1,000,000 A EXCESS LAD CIASIS.M AOE AGGREGATE S 1,000,000 DEO I X I RETENTIONS 5,000 48-791-150-02 4/12/2013 4/12/2014 s B WORKERS COMPENSATION X XI TreysTLIAMITSI ICER AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N NIA 1/11/2013 1/11/2011 (MondetorylnNH) 83052240 E.LDISEASE-EAEMPLOYEE$ 1,000,000 It yyI�L.desaSe L'Rder DESCRIPTION CF OPERATIONS below EL DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more apace is required) CERTIFICATE HOLDER CANCELLATION (321)868-1247 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Cape Canaveral ACCORDANCE WITH THE POLICY PROVISIONS. 7510 N Atlantic Ave Cape Canaveral, FL 32920 AUTHORIZED REPRESENTATIVE F Juarez/ERYNZA I"-"' �� -' ACORD 26(2010106) 01988-2010 ACORD CORPORATION. All rights reserved. INSO2S onirvtci n; The.Ar:rlPf name anti Innn aro ranlafe.rari raarlra of Ar:r1Rr1 Form Wm9 Request for Taxpayer Give Form to the (Rev.August 2013) Identification Number and Certification requester.Do not Department of the Treasury send to the IRS. Internal Revenue Service Name(as shown on your Income tax return) Doug Hambel's Plumbing,Inc. N Business name/disregarded entity name,it different from above o co aCheck appropriate box for federal tax classification: Exemptions(see instructions): o ❑ IndlvduaVsole proprietor ❑ C Corporation ❑S Corporation ❑ Partnership 0 Trust/estate 0 Exempt payee code(if any) o ❑ Limited liability company.Enter the tax ciassification(CoG corporation,S=S corporation,P=partnership)► Exemption from FATCA reporting code(if any) y` 0 Other(see instructions)e. • Address(number,street,and apt.or suite no.) Requester's name and address(optional) a 4190 Dow Road • City,state,and ZIP code CO• Melbourne,FL 32934 list account number(s)here(optional) Part I Taxpayer Identification Number(TIN) Enter your TIN In the appropriate box.The TIN provided must match the name given on the"Name"line I Social security number to avoid backup withholding.For individuals,this Is your social security number(SSN).However,for a resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other — — entitles,it Is youremployer Identification number(EIN).If you do not have a number,see How to get a 77N on page 3. Note.If the account Is in more than one name,see the chart on page 4 for guidelines on whose Employer Identification number number to enter. 5 9 — 3 0 0 1 8 8 6 Part II Certification Under penalties of perjury,I certify that: 1. The number shown on this form is my correct taxpayer Identification number(or I am waiting for a number to be issued to me),and 2. I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all Interest or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding,and 3. I am a U.S.citizen or other U.S.person(defined below),and 4.The FATCA code(s)entered on this form(If any)indicating that I am exempt from FATCA reporting is correct. Certification instructions.You must cross Out item 2 above If you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage Interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other than Interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions on page 3. Sign Signature of ,�/�/f, Here u.s.person► A At a�� ///IV/ /1 Date'. /7 /10/7' General Instructions YJYu WW withholding tax on foreign partners'share of effectively connected income,and Section references are to the Internal Revenuo Code unless otherwise noted. 4.Certify that FATCA code(s)entered on this form(if any)indicating that you are exempt from the FATCA reporting,is correct. Future developments.The IRS has created a page on IRS.gov for information Note.If you are a U.S.person end a requester gives you a form other than Form about Form W-9,at www.irs.gov/w9.Information about any future developments W-9 to request your TIN,you must use the requester's form if it Is substantially affecting Form W-9(such as legislation enacted after we release it)will be posted similar to this Form W-9. on that page. Definition of a U.S.person.For federal tax purposes,you are considered a U.S. Purpose of Form person If you are: •A person who is required to file an Information return with the IRS must obtain your Intlivltlua who is a U.S.citizen or U.S.resident alien, correct taxpayer identification number(TIN)to report,for example,income paid to •A partnership,corporation,company,or association created or organized in the you,payments mode to you in settlement of payment card and third party network United States or under the laws of the United States, transactions,real estate transactions,mortgage interest you paid,acquisition or •An estate(other than a foreign estate),or abandonment of secured property,cancellation of debt,or contributions you made to an IRA. •A domestic trust(as defined in Regulations section 301.7701-7). Use Form W-9 only it you are a U.S.person[including a resident alien),to Special rules for partnerships.Partnerships that conduct a trade or business In provide your correct TIN to the person requesting It(the requester)and,when the United States are generally required to pay a withholding tax under section applicable,to: 1446 on any foreign partners'share of effectively connected taxable Income from such business.Further,in certain cases where a Form W-9 has not been received. I.Certify that the TIN you are giving is conect(or you are wailing for a number the rules under section 1446 require a partnership to presume that a partner is a to be issued), foreign person,and pay the section 1446 withholding tax.Therefore,if you are a 2.Certify that you are not subject to backup withholding,or U.S.person that is a partner In a partnership conducting a trade or business in the 3.Claim exemption from backup withholding if you area U.S.exempt payee.If United States,provide Form W-9 to the partnership to establish your U.S.status applicable,you are also certifying that as a U.S.person,your allocable share of and avoid section 1446 withholding on your share of partnership income. any partnership income from a U.S.trade or business Is not subject to the Cat.No.10231X Form W-9(Rev.8-2013) s`r� l, STATE OF FLORIDA ', ' cs' 'w- , �f ? DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ` ":_w ,: • CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 HAMBEL, DOUGLAS WILLIAM DOUG HAMBEL'S PLUMBING INC 4190 DOW ROAD MELBOURNE FL 32934 • Congratulations! With this license you become one of the nearly one million ,• • K. 8 > � tisxlis & Floridians licensed bythe Department of Business and Professional Regulation. ' -'. $ • ,'� Our professionals anbusinesses range from architects to yacht brokers,from t' .'�` • •S -' G 'L � a j a rq ) '::1 : boxers to barbeque restaurants,and they keep Florida's eronorny strong, .'..,,: -.''..:1,1••-,:. .. '-;•,, �`�* ` i T7$ 8 ytI)1 sTO'0 4-Y Every day we work to improve the way we do business in order to serve you better\:-- -;i;:,_:•-' • 4 �'�`�;,�, }:-' ;R; ,rt' :• For information about our services,please log onto www.myfloridalicense.com. ••r•�=;•a� ���`'',�+��r•c ���t:re\�, ""'h.�=- There you can find more information about our divisions and the regulations that '.:P- ,r: : o oi, �: ,. , �. .a.' "t Impact you,subscribe to department newsletters and learn more about the :::Art:''" ,"= =. r ) r2 ' v ' ' '�7,r r Department's initiatives. ..1 ,-;-,,,,,j,., :046 ,i. - ,, y x Our mission at the Department is:License Efficiently,Regulate Fairly.We 'e. : 3'.•.•;-'-''=(4:-.<,"`:f/,., •<.1.wi *.. r tt`ii':,ar ,. •. :»•:.irk€,:=,:�, �: ..:�; , t r,;.' ,..`: . r">'..<'• ., 'l !- •;'- ;-, �-.; ,it._;. . constantly strive to serve you better so that you can serve your customers. { r � � „ - Thank you for doing business in Florida,and congratulations on your new license) Y. ,- ,; A. r • ' DETACH HERE -- THIS DOCUMENT HAS A COLORED BACKGROUND•MICROPRINTING•LINEMARK"PATENTED PAPER • � ') TF+r _per-'FLb? /�'!.' .i;�.'_.. •t:•`..:. :17:.• ;f ::': -,. .� . i. . - •.i .'".s'•J,�",�'. 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J `js ''�%"`x`•~::�,. _ .:L•:..... Li4( JJJ/CCC � -- �t'^' - ..c.:+f.,' /�7 �,�p.�rc� �.��j� a9+9 lw .lit_.,,—;i • • ti9:0•1):OAr RO .. . Co ! ,E �i 4 t V.�1;.i. t.• �F �a Y' :•3 . t� + ^" y�'`j> &\44 '2►'�1KS''` y _ - `• ^+j��. . :;. ' �•� "�<-,• lr; _'. : ��+r, _ , ► KEN LAWSON , x '3F.• . •� ... 'SECRETARY - 01V-2..• nrconsAv ne:oclirirocn li r I•A1nr.... •-.1' . • BREVARD COUNTY BUSINESS TAX RECEIPT ACCOUNT NO. 20�3 2014 SUBJECT TO COUNTY ZONING RESTRICTIONS 885001372 TAX RECEIPT SHOULD BE DISPLAYED ON PREMISES THE PERSON(S),OR ENTITY BELOW: BUSINESS PERIOD: OCTOBER 1, 2013 — SEPTEMBER 30,2014 EXPIRES: SEPTEMBER 30,2014 DOUG HAMBEL'S PLUMBING INC ISSUED PURSUANT AND SUBJECT TO FLORIDA STATUTES AND BREVARD COUNTY CODE ISSUANCE DOES NOT CERTIFY COMPLIANCE WITH ZONING OR OTHER LAWS. 4190 DOW RD BUSINESS TAX RECEIPT IS SUBJECT TO REVOCATION FOR ZONING VIOLATIONS,AND/OR FAILURE MELBOURNE FL 32934 TO MAINTAIN REGULATORY PRE-REQUISITES AS REQUIRED FOR BUSINESS CLASSIFICATION(S),OR SUBSEQUENT ACTIVITIES. NOTIFY TAX COLLECTOR UPON CLOSING OF BUSINESS. A PERMIT IS REQUIRED TO ADVERTISE(Inducing with signage)'GOING OUT OF BUSINESS°. LISA CULLEN,CFC,Brevard County Tax Collector LOCATION: P 0 Box 2500,Titusville,Florida 32781-2500 • (321)264-6910 4190 DOW RD UNINCORP.DISTR.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 $00 300480 PLUMBING CONTRACTOR 820005 2013-2014 RECEIPT AMT $37.00 Vk ',P41"0-ANl ty1g"`�?H`kL-E DATE 41W\T PAID P,.1D=`1AZ.1;5 :. •k01.-0g0iJ 3 08/0 ,e013,37.00 ti .7-y C ,.t '7 (r)re� - = ` C'r., 6 t•�� C5�'ri4c'.![-R�'h]iir;';-v �Cc:`• ��''a•�4-y ,,` qy . I ) 1 k. v 6 f .4 Lki: p ) i�. f p (t' BRANCH OFFICES: Merritt Island Office,1450 N.Courtenay Pkwy,Merritt Island, FL 32953 Melbourne Office,1515 Sarno 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 BTR-D CPT-04 Electrical Contractors Paper work Best Electric 02/24/2014 15:22 3217236793 BEST ELECTRIC OF PB PAGE 02/04 Turnkey Construction 4Z 14tV:,W0 N.s; e/-, CITY OF CAPE CANAVERAL • r - ik AUTHORIZATION FORM . City ofCape Canaveral Building Department 7510 N.Atlantic Mc. Cape Canaveral,FL 32920 (321)ta68-1222 (You download this authorization:. isitiofrapssawiAllgArg. You may fax to:(321)863-1247. Date: " 1 k- \LA 7 pmt CONTRACTORS AND SUBCONTRACTORS-PLEASE HAVE YOUR SIGNATURE NOTARIZED ►ti SUBMIT THIS FORM WITH T.o.•ti • I ..k •LICATION. Company N e! 'S S .._0 Q.\m • 0_‘) r\ I, t�4 p,�,aP4 C ,hereby authorize 0.1-.10,6 k,..jX CSSC(11 ;Star Limns Holder's Name-PLEASE PRINT) (Auherized Person-PLEASE P1W41) to obtain a permit on my behalf under my state license(s)as issued by the Department of i l Business and Professional Regulation,Construction Industry Licensing BoardRoo,"133 , (Soto Lamar Nwnburta)) for the job site described below. An authorization will tie regtcirod f yr eade permits T of Penult S\- coo. L Q. Building Name of {{perty Owner P tmabwg _ CK1e- Electrical .Address of Job Site Mechanical Roofing �..1\._ 1 � l Swimming Pool �-,V Specialty Structure Specialty of License Holder Other—Specify: For Notary use only: State of Florida,County of Bowan! + Lk \ Swan and subscribed before me this ?,day of ,20 l1 ,by O r N crlrlp 4..&r- Naare of Appliacu E----who Foduced identiification:pp pc tpSki.L('? • 63' or --- is personally known to toe. 3a>~o Seal: .w: • tLAP! MrSignature-Nott Pubtio At Tr GAB1da.Deor.ForruskAutho[tatinnForteditA C.A6ORRE- Nolary Public-Stale o1 Florida This form may troduptiedated +y comm.Expires Mar 4.20t6 ;.` J�• = 175480 (;gmmi5si0��EE Contractor/Roofer Contractors Paper work Turnkey Construction BUILDING PLANNING TABLE R308.3.1(1) MINIMUM CATEGORY CLASSIFICATION OF GLAZING USING CPSC 16 CFR 1201 GLAZING IN DOORS AND GLAZED PANELS i GLAZED PANELS ENCLOSURES GLAZING IN STORM REGULATED BY REGULATED BY REGULATED BY SLIDING GLASS EXPOSED SURFACE OR COMBINATION GLAZING IN ITEM 7 OF ITEM 6 OF ITEM 5 OF DOORS PATIO AREA OF ONE SIDE OF DOORS DOORS SECTION R308.4 SECTION R308.4 SECTION R308.4 TYPE ONE LITE (Category Class) (Category Class) (Category Class) (Category Class) (Category Class) (Category Class) 9 square feet or less I I NR I II II More than 9 square feet II II II II II II For SI: 1 square foot=0.0929 m2. NR means"No Requirement." TABLE R308.3.1(2) MINIMUM CATEGORY CLASSIFICATION OF GLAZING USING ANSI Z97.1 DOORS AND ENCLOSURES GLAZED PANELS REGULATED BY GLAZED PANELS REGULATED BY REGULATED BY ITEM 5 OF EXPOSED SURFACE AREA OF ONE ITEM 7 OF SECTION R308.4 ITEM 6 OF SECTION R308.4 SECTION R308.4" SIDE OF ONE LITE (Category Class) (Category Class) (Category Class) 9 square feet or less No requirement B A More than 9 square feet A A A For SI: I square foot=0.0929 m2. a. Use is permitted only by the exception to Section R308.3.1. 5. Glazing that is adjacent to the fixed panel of 4. All glazing in railings regardless of area or height above patio doors. a walking surface.Included are structural baluster panels 3. Glazing in an individual fixed or operable panel that and nonstructural infill panels. meets all of the following conditions: 5. Glazing in enclosures for or walls facing hot tubs,whirl- pools,saunas,steam rooms,bathtubs and showers where 3.1.The exposed area of an individual pane is larger than 9 square feet(0.836 m2);and the bottom exposed edge of the glazing is less than 60 inches(1524 mm)measured vertically above any stand- 3.2.The bottom edge of the glazing is less than 18 ing or walking surface. inches(457 mm)above the floor;and Exception:Glazing that is more than 60 inches(1524 3.3.The top edge of the glazing is more than 36 mm),measured horizontally and in a straight line,from inches(914 mm)above the floor;and the waters edge of a hot tub,whirlpool or bathtub. 3.4. One or more walking surfaces are within 36 6. Glazing in walls and fences adjacent to indoor and out- inches(914 mm),measured horizontally and in a door swimming pools,hot tubs and spas where the bot- straight line,of the glazing. tom edge of the glazing is less than 60 inches(1524 nun) Exceptions• above a walking surface and within 60 inches (1524 • mm),measured horizontally and in a straight line,of the 1. Decorative glazing. water's edge. This shall apply to single glazing and all panes in multiple glazing. 2. When a horizontal rail is installed on the accessible side(s)of the glazing 34 to 38 7. Glazing adjacent to stairways, landings and ramps inches (864 to 965) above the walking within 36 inches(914 nun)horizontally of a walking sur- surface.The rail shall be capable of with- face when the exposed surface of the glazing is less than standing a horizontal load of 50 pounds 60 inches (1524 mm) above the plane of the adjacent per linear foot (730 N/m) without con- walking surface. tacting the glass and be a minimum of 1'4 inches(38 mm)in cross sectional height. Exceptions: 3. Outboard panes in insulating glass units 1. When a rail is installed on the accessible side(s) and other multiple glazed panels when of the glazing 34 to 38 inches(864 to 965 mm) the bottom edge of the glass is 25 feet above the walking surface. The rail shall be (7620 mm)or more above grade,a roof, capable of withstanding a horizontal load of 50 walking surfaces or other horizontal pounds per linear foot(730 N/m)without con- [within 45 degrees(0.79 rad)of horizon- tacting the glass and be a minimum of 1'/2 tall surface adjacent to the glass exterior. inches(38 mm)in cross sectional height. 2010 FLORIDA BUILDING CODE—RESIDENTIAL 3.23 CITY OF CAPE CANAVERAL -=' AUTHORIZATION FORM City of Cape Canaveral Building Department 7510 N.Atlantic Ave. Cape Canaveral,FL 32920 (321) 868-1222 (You may download this authorization: www.cityofcapecanaveral.org. You may fax to: (321)868-1247. Date: 2- I l 1 q Permit#: CONTRACTORS AND SUBCONTRACTORS - PLEASE HAVE YOUR SIGNATURE NOTARIZED AND SUBMIT THIS FORM WITH THE PERMIT0_,crd APPLICATION. Company Name: 66-\c\ S\NOMS O C 1 Ior A 9 1, Oo\- rSkccicVe C , hereby authorize @.\rOà (State License Holder's Name—PLEASE PRINT) (Authorized Person—PLEASE PRINT) to obtain a permit on my behalf under my state license(s) as issued by the Department of Business and Professional Regulation, Construction Industry Licensing Board 2J\C tB q5\, {State License Number(s)} for the job site described below. An authorization will be required for each permit Type of Permit 8\1e L_Le Building Nam of Property Owner Plumbing \35 coN, La,� Electrical Address of Job Site Mechanical Roofing Swimming Pool Specialty Structures afore of Lie e Holder Other-Specify: For Notary use only: State of Florida,County of Br vazd �-�- Sworn and subscribed before me this 7 day of j,�'.) ,20/ ,by-N-1 cinctc--..e,r Name of Applicant who produced identification:cL 7C r. h.-"0044 or is personally known to me. aw°ut Notary Public State of Florida ed1 Seal: ? Deanna Pomichter 47 My Commission EE073304 Signature:Notary Public At Large e 'ed„o4 Expires 05/11/2015 G:\BIdg.Dept.Fonns\Authorization Form This form may be duplicated.