HomeMy WebLinkAbout521 - 523 WASHINGTON AVENUE - 1.pdf:$74,
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Issued to —.
CITY OF CAPE CANAVERAL
BUILDING DEPARTMENT
Sordtary Sewer Permit
FEE $5:00
Permit
' Legal Description
Far one: ebnred'on at ___ -
Subd
Lot '"i-:-- Block -
Classification:
Single Dwelling alfa 0aIhs
Multiple Dwellin) Clos I ( h Class II (
No. �u IIs No units
Hotel or Matti 1 ) Public fildg•.:
No. units t
Trailer Park (.- ) DoimilorY
No. units
Assembly Hall Commerdol
Indust:int School
lit considerailan of permission givenof tho Plumbing Ordinance °gree 'h emrvc. said work l mPliance with the provisions
of the City of Cape Canaveral, Float:ie.
d Add ess
0‘5000.1
igne
Owner Plumber
uildmg omuelp
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BUILDING PERh1�B ' APF'L9C/�T0®I®1� "�
Jurisdiction of CITY OF CAPE CANAVERAL
Applicant to complete numbered spaces only.
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.logADDRESS x DATE t -
LEGAL LOTNO.
1 OESCR. IPSFPe
.,. TRACTf _.. IaSEE ATTACHEDSHEET)
Owner Mulling Atl ZIP
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Gg Con r. Mullin *dense Phone so No. C
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Elec. Contr. Mulling Address Phone Morn. No. C
4
Mob. Contr. Malting Ac .5405 Phone. License No. CC.
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Mach. Cont,. Mulling Address Phone License No. CC
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USE OFBUILDING
0
8 Clasg afwork: ❑NEW ❑ADDITION El ALTERATION ❑REPAIR ❑MOVE ❑REMOVE
01
9 Describe work:
10 Valuation of work:
NOTE: REQUIRED INSPECTIONS MUST BE ARRANGED
TEL: 783-1100 ALLOW 4 HOURS RESPONSE TIME
.._
SPECIAL CONDITIONS
DNB.
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MINIMUM PARKING REQUIRED >:. SHOWN:
IT t )S t;
SETBACKS F R RS LR
1
U eilre
Required Sprinklers CaYeo-sfo
pllaatyon Accepted BV•-
eked ey: IApprgvC F Issuance u ncc By
Z
No. of
Dwelling UnIIS
na
OFFSTREET P:,flKING PACES
Coaer 10 00 000 2
1 1 ApPro 1
Required
Received
11
N 0 TIC E
PLUMBING, HEATING,
ZOG
111.11111.1111
PERMITS R REQUIRED R ELECTRICAL
VENTILATINGRAICONDITIONING.
HEALTH DEPT.
111111111.11
TF IS PERMIT BECOMES NULL ANDVOID 16 WORK OR NS
WITHIN 6 MOS. OR
FIRE DEPT:
IMMINIMI
TION ALITHOMEED N US
IF CONSTRUCTION O0. WORK IS SUSPENDEDOR ABANDONED FOR
SOIL REPORT
PERIOD F 1 YEAR AT ANY TIME AFTER. WORK IS COMMENCED:
OTHER,(SpecllY)
IS EE ORDINANCE3.704
I HEREBY CERTIFY. THAT I HAVE READ AND EXAMINED THIS
TRUE AND CORRCCT.
V
APPLICATION AND KNOW THE SAME TO BE
ALL PRO I I OF.LAWS AND ORDINANCES GOVERNING THIS
'PERMITS
& FEES
CODES
TYPE WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
OFA DOE NOT PRE
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t d
Ile P Manua..
HEREIN NOT THE RANTING PERMIT
SUMS T IVE AUTHORITY TO VIOLATE C CL THE PRO-
01,,c1 1c.
1001019
. _ 3
N tl I EI I •
VISION OF ANY OTHER TE on L L wREGULATING
O CONSTRUCTION.
p mblPg
�-
110 St tl
CONSTRUCTION OR THE P-RFORMAN.E
.�:.�
South Standard•
Signature of Contractor orAuthor Iced Agent lOal01
Other
1 0 T A L
.5 �, -
cu ant edition & o,oantlmonts.
Sfgneture of Darner (11 Owner sunder)100101
WHEN PROPERLY VALIDATED (IN
THIS SPACE) THIS IS YOUR PERMIT
THIS APPLICATION, SIGNED, BECOMES A PERMIT TOSTARTWORIO1.:
BUILDING OFFICIAL
c4' _ _1 - CITY
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OTI
PRECORDED)
f u� t2 fjy ;7/.);
'ev-:3 x'73
�ccel�:(sc
TODAY'S DATE
;URE
t 3J,00 iACEVTor•
f I + J approval of legal
'I -1'''44'•33 th an association
i �) �— have approval...
'Others is to. include '.ovenants„;:conditions & restrictions as:
recorded on deed.
CSTY OF CAVE CANAVERAL
PERMIT APPLICATION
TRIS IS NOT A PERMIT TO START WORK, IT IS AN APPLICATION ONLY
AND WILL BE PROCESSED -AS 5OON A5 POSSIBLE, YOU WILL BE CALLED
NHEN. IT IS READY..
COMPLETE. THE FORM BEL
CURRENT COPY OF THE. FOLLO:']IN(
County License and Competency Card
Liability and Workmens Compensation Ins0urance (10,20 ,5000)
Surety Bond payable to this city ($1,
W AND INSURE YOU HAVE ON FILE A
(HOMEOWNER PERMITS ARE EXEMPT)
TYPE OF PEINIIT: _ BLDG- ELEC. PLMBG.
PROPERTY OWNER:
STREET NO.....
STREET
PROPERTY LEGAL: LOT _-
BLOCK SUBDIV.
CONTRACTOR:
TEL:
ADDRESS:. -�_-:
NATURE OF WORK TO BE DONE:
MECH.OTHER.
S RECORDED)
VALUATION OF WORE/CONTRACT:
Office use only
Verification:
County License__
Competency Card_ gIGNATURE
Insurance LICENSEE OR AGENT OF
Surely Bond RECORD OR OWNER..
City License
TODAY'S DATE
NOTE:
Work for a lessee ,..rentor. -manager, . agent,: must have approval of legal
1 owner of record.
Homeowners, condominiums, townhouses, or *others, with an association.
controlling architecture and building criteria musthave approval
signed by the, governing. body.
*Others is to include covenants, conditions & res''+ctions as
recorded On deed
STATE STATUTE REFERENCE NUMBERS
553.900, 553.904, 553.907
AS REQUIRED BY FLORIDA STATUE, 9553.907, ACTING AS OWNER,
OR OWNERS AGENT, I CERTIFY THAT THIS STRUCTURE COMPLYS
NITI-I THE REQUIREMENTS FOR THERMAL ENERGY EFFICIENCY AS
STATED IN APPENDIX "J" OF THE STANDARD BUILDING CODE.
OWNER
OWNERS AGENT
DATE