HomeMy WebLinkAbout525 - 527 WASHINGTON AVENUE - 1.pdf811511.I
BUILDING PERMV911T APPLICATION
JurIsd:ctlo0 of
CITY OF CAPECANAVERAL
105 PO k:A enue
Joe ADDRESS DATE:
LT NO.
4 Et1A4
1 D SCR.
ILK.
RP.nT
(Q SBE A'fTgCHEO SHEET)
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..,
OWnv,.: 81011110 Adams. ZIP
2
Dem Conir, MailingA00ro01 PKOnn 11cans0Nn,
3
Else. Contr. AP...sMailing A0a l 7 50°5' License No.
PI18, COntr. M0Mpg 8001010 50000 License No.
6
Avco-COnt0 Ma0Ine Address 'Phone Llc0ns0 NO.
t! S0 OF BUILDING
8 Class of work: ONEW 0ADDITION ❑ALTERATION ❑REPAIR ❑MOVE - ❑REMOVE
9 Describe work• ,._ .r r ...... , : , ,... � ,"
10 Valuation of work: --T
NOTE: REQUIRED
TEL:783.1100,
eco 1�
Canss 1E (nL
51 010100, 0 l f l
(T tall en -FI. 1
INSPECTIONS MUST
ALLOW 8 HOURS RESPONSE
coup^nry
O ouol
)0rl0s
':..,r.
BE ARRANGED
TIME
Owislon ,--
SPECIAL CONDITIONS:
'.
5000ACKS F RS LS 0
Flre
Use
FI Sprinklers
I dOVes.0.50
Application gccoptadBy:
Acuoa ey I050100odF Iuuancn 00
_
No. of
Dwelling Units—
OFFSTREET PARKING$PACES
Covered
I Uncov
REQUIRED
red
NOTICE
PERMITS AREREOUIRED FOR ELECTRICAL, PLUMBING, HEATING,VENT1-
LATING OR AIR CON01T ONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTIONAUTHO
TION OR NOTCOI E WITHIN I WORKZED IS SUSPNLEDOR 008500NED FOR APERIOD OF 8.
MON11-15,
I HEREBY CERTIFY THAT I HAVE READ 0800 XAMINEDTHISAPPLICATION
AND KNOW THE 5Ah1ET0 BETRUE AND CORRECT -ALL PROVISIONGOF
LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE
COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT..THEGRANTI1If,:
00 A PEERMITDOES NOT PRESUME TO GIVEAJTHORITYTO VIOLATE OR
CANCELTHE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGU-
LAT 1f�G CO S UCTI/O)N 0C0'THE /0ER RM080&UF CONSTRUJCTTIION.
,I /N=' l.. lF, ,+ q`fiLd'CCIY1 V S':/ i f 1O u...
0010111 000raval1
80nu1, 0
Received
Not ^ov..roJ-
005100
HEALTH 0EPT.
FIRE REP
BOI8 REPORT
OTHER (Specify)
////T////////
/ ///1/
PERMITS
81 FEES
CODES
Buang
., i:'. _11'7
go uI00IP SI0n000
lc
$ 19.OC
Nene al El elks
P100 1ne
g dud g Islrq•
MttMncvl
000 0Mttnani00
0,,o,
Slgnntute di Cantsactor or 0,15T1 aq gent (Dale)
TOTAL
.1 9))
a1nLop00 v !d0 nc.
slgnalur5Ol Owner (II wner0011der)I0 tel
THIS APPLICATION, WHEN SIGNED, BECOMES A PERMIT TO START WORK:,/ %�
:rte F:/�^-'��'
BUi LE/ ING'OFFICIAL `!"
ERAI.
"YII.ISID".G FISMIT APPLi CAT) ON
PEr JT T[ STMT POW:;-I'L IS AN. T+PPLICATIOV: ONt RND't4CL,L BE PR(ICES..EC)
AS SONS PGSSILLD. 1c.17.: WILL BE. CALLED WIIEN IT IS READY.
CY.Y IPII;IE Ili 1111..51 7 If13C7RE TIL55 YOU HAtfi CAV FILE A CURRENT C7F='I 17' THE WIL1c1T1t
(:'04'n::511715 PERM I^ 15.E 1101 MPT):
State License
County Livens, and Competency Card
Liability 7$10, SIC, $5 Theusncd), and.:Workman'a. Compensation Insurance.
Surety Bond payable to this City ($1,000); only if City Coo. License required.
'B OF 507510Ti BLDG. -V ELEC. ✓ PLUMB.. MECH.. OTIGR
I. DRT1 OMER: soyiy gcaiFI ran/ ADDRESS: 527 bt//nq,.✓1rty
PHONE 4: ler %6cy
: ET ADDRESS OF JOB SITE: 07 W0/4/NGT !"fr
_ixAL. DESCRIPTION: 101` 7 . 3117170 S SUB. 141'404/ - r'y /)fc'. %/9'
OTHER
,ONTRACTOR: STATE LIC. 4:
ADDRESS: PHONE 4:
l7Ma79 1519 t3
ELECTRICAL 'COA'TR?CTOR: +WE9CA EZEc7-0/1. 40 STATE LIC. 4:
ADDRESS: 50 is (iRi./POa .9VE cocon veArbi PHONE 4: 78) 7030
PLUMBING CONTRACTOR: STATE ITC.
ADDRESS: PHONE 4.
N EHANICAL CONTRACTOR: STATE LTC. . 4:
ADDRESS: /1 PHONE 77:.
NATURE OF WORK '10 BE DONE: elor /5` -X/ii/VG 5aivDEc C 8v ff00
NEW N'e'0D )750)0 /FYP $79/17i.
VALUATION OF LURK/CONTRACT: $ /9MM x g Coo
Note: This application is valid for 15 working days after which time, unless a
permit has been drawn, this form and alltattached material will be destroyed.
Date: r/g/�% /
Signed: g
Licensee or'Xgent of Record o
OFFICE USE ONLY; VERIFICATION: 51 ! 6 i' `J 41.1 (Ip '
Gen. Contr. Elea. I.».-Plbg 1 Mech.
Insurance
Card / !Itat / /'. � /
Insurance \ /?(trr✓/7/ntfu 'l ! +i /
Surety Bondd / ,li/,4- / ) e� /
City License \/ ' ,(//& / ..0J-'
State License /LR()ou9/6..7 )n// •:‘
County License /r5C-/Lt�� /
Work for a lessee, rentor, managed agent must have approval of legal owner of reC
Homeasners,: condominiums, townhouses or others*, withan association control, archi-
tecture and building criteria, must have approval signed by the governing body.
*others is to include convenants, conditions and restrictionsas recorded on deed;
however, this office is responsible only for obtaining compliance with the Zoning
arcw�u,�i. :1'IARCH 1984.
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East %a of GoT Z B/k.5, Avon- By - 777¢ - 523
. AS r CO/'D£D IM PLAT 800K 3 , PAD! 7 Of T4E PU®EJC RECORDS OF
:..D?E✓ARO COUNTY, FLORIDA
DATE or
CERrHT,c4r/. ISURVLrY
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CITY OF CAPE CANAVERAL'
BUILDING DEPARTMENT'.
Sanitary Sewer Permit
FEE$5.00
Permit 1.tt is
Date 7_3/ _a0..
Issued le r` 1�t21 r 440D/
Address
575/:
For one connection ot —.7.527 \;/ VA -54 GTON3 Legal Description
tt
Lot 7 Block-'Subd. b\1O1\I ts { TkiIt
Cletrgraeon
Single Dwelling
t;� 2. KT4
Entre Baths
Multiple Dwelling — Clew I (_ . - k Clew II
No. units No. unite
Hotel or Motel ( ) Public Bldg
N. units I
Toler Perk ( ) Dotmitoty A.SS -SS
No. units
Assembly Hall Commercial 'l=
Industrial
yr k,,00 -7 -.
School (oFfiL_
. i,(35e
In consideration of permission Divan
hereby agree to construct said work Mdo
of Ih City of Cape Ceneverei, Florida: compliance with h prwislo of the PIum6ing Ordinaries
Signed
Address
Owner. –�s
- Plumber6 � _ t/
r B Hd g OHIF.iI
e
BUILL)ING PERMIT APPLICATION
Jurisdiction of CITYOF CAPE CANAVERAL'.
Applicant to coglplete numbered spaces enly.
JOB ADDRESS
DATE:
1 OESOR,
OT NO,
�,
LK.
T C
j T` ([J,9EE ATTACHED SHEET)
}
O no M 11179 Address
GIP PM1 ao
'
IQ
Pina Address Phone ImmoNa cc
3
.L.:-
ElmContr, Making AEdret1 Phone Meanie Na. C
4 C.
1.
VV
Plme. Contr. : S Addrass : Phona License No. CC.
6
Mall
Mech, Contr. Mollies Address Phone License No. C C.
6
\. >
(�
USE OF BUILDING
s,)
!J )
8 Class of work: ❑NEW ['ADDITION ❑ALTERATION ❑REPAIR ID MOVE ['REMOVE
:L/1
9 Describe work. :, s..
NI
10 Valuation of work: ,. -
NOTE:. REQUIRED INSPECTIONS MUST BE ARRANGED
TEL 783-1100 ALLOW 4 HOURS RESPONSE TIME
SPECIAL CONDITIONS:
vP "'.
Type nt
•neer•
Dp eunancY
Grapp Vit
, »..
DlmsmP`
Sire of Blue..
(T tall: no. rt.
No. of
Stades
Max.
Om
cc.Load
MINIMUM PARKING REQUIRED. SHOWN:
SETBACKS F - R R5 _: L5
Fl
Zone
Usa
Fra5 rinkl0S
qulietl Yes No
gplleallan ccepta.0 By.:
I ked By
:
00,00 d E 11snanco By:
f
D Ilina. Units
OFFSTREET PARKING
Covered
PACES
IUna...
N 0 T) C E
PERMITS ARE REQUIRED F. ELECTRICAL, MSING. HEATING,:
VENTILATING 00 AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUG
TION AUTHORIZED IS NOT COMMENCED WITHIN 6 MONTHS, OR
IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED. FOR
A PERIOD OFN1 YEAR. AT ANY TIME AFTER WORK IS COMMENCED
(SEE ORDINANCE 3-]a.)
HEREBY CERTIPV THAT I HAVEREAD ANO'EXAMINED THIS
APPLICATION AND. KNOW THE SAME TO BE TRUE ANo CORRECT.
LL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
TYPE OF WORK WILL. BE COMPLIED WITH WHETHER SPECIFIED
HEPEINNOT.EGRANTING OF MIT ES NOT PRE.
TO GIVE AUTHORITY OVIOLAT -CANCEL THE PRO(
F ANY OTHER STATE O ALF W REGULATING
CONSTRUCTION ORTHE PERFORMANCE OF ONSTRUCTION. -
Special APprovals Approvals
Required
Reoelved
Not RegUlred
ZONING
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER:(SpeclfY).
111.11 111/1
90081554
111111111/1)1.11111111f1111111
0006 �..,
-
CODES.
1Ildlna
,.
Soulhorn standard:
•SUPE
aar..
0ltVISIONS
"-_"�
National Elacrc
PlumhPla
�y4�'I ...e
Southern Standard,
Mechanical
e^ "
Southern Standard
tactor or
Sion.), al Authorized Aeont (Dale)
Other
r:_h
T 0 T A
?.L' "t
. corm eItlon a a men0mants.
SNnature of Owner 11105ner3611505 (Date)_.
.WHEN rnurEHLV VALIDATED IIN' TH15 SPACE I TH1510 YOUR PERMIT
THIS APPLICATION, WHEN SIGNED, BECOMES A PERMITTO START WORK: 'y.
;: �BUI,11DING OFFICIAL
LA
I l%� CJI 20.0.
794 x 10.0
1-760
'SAUDIi4C-G
ONLY
..,�F�,._.r.�-a�-.z-_��:,�'.,�.-•r.`' ;"'� 1'wl..-FFILLED
CITYp E A.
EMPT)
39 SS''o
940 '' 131, 0+ 25`
G7,52a
22— G, 4v
- la— 3.60
Lt re '1— 2.20
PoG,
— 1. 5o
G— I.00
DisP.-2—.1 so
0o 2 ) ,HO
_62J— 1 5.00
iusP — 1 3.00
�c �c 25.2c)
j 1EGI
22.00 ftm Ccn=
we --3 6. cc,
1A/ -- 3— 6.00
Toe/ -..we Z---4 .00
51NY — 1 —2,00
D,SP— f —2,0o
1 —Z.00
w F1 —2,00
sawefL- 1 — 1.60
Ir,iae— , g-oo
Others is to inclu0e covenart , cone i. do
recordedon deed:.
1s
20 ,5000)
[. °VIER.
RECORDED)
lfi-v-z
WY -.3e73
TODAY'S DATE
UIlE
1 ACENT OP
)NNER
approval of legal
th an association
have approval
restr1.tions as
ciTY:. or '.CAPE CANAVSRAL
PERMIT APPLICATION
THIS IS NOT A PERMIT TO START WORK, IT IS AN APPLICATION ONLY
AND WILL BE PROCESSED AS SOON AS POSSIBLE, YOU WILL. BE CALLED..
WHEN IT IS READY.
COMPLETE THE 50039 BELOW AND INSURE YOU HAVE ON PILIE A
CURRENT COPY OF THE FOLLOWING (HOMEOWNER PERMITS ARE EXEMPT)
County,_License .and Competency Card
Liability and WorkMensCompensation Insurance (10,20 ,5000)
Surety Bond :payable to this city ($1,000)
TYPE OF , PERMIT: BLDG. ELEC. PLESBG. MECII. OTHER..
PROPERTY OWNER: (AS RECORDED)
STREET NO. - STREET
PROPERTY LEGAL: LOT BLOCK SUBDIV.
CONTRACTOR: _ +
ADDRESS - TEL: - -
NATURE OF WORK TO BE DONE:
VALUATION Or WORK/CONTRACT:
Officeuse only
Verification:
County License
Competency Card
Insurance SIGNATDRE
Surety Bond LICENSEE OR AGENT C<
City License RECORD OR OWNER.
TODAY'S DATE
NOTE:
Work for a lessee, rentor, manager, agent, must have approval of legal
owner of. record
Homeowners, condominiums, townhouses, or *others, with an association
controlling architecture and building criteria must have approval
signedby the governing body.
*Others is to include covenants, conditions ..-& restrictions as.
recorded on deed.
STATE STATUTE REFERENCE NUMBERS
553:900, 553.909, 553.907
AS REQUIRED BY PLORIDA STATUE, x553.907, ACTING AS OWNER
•
OR OWNERS AGENT, I CERTIFY THAT THIS STRUCTURE COMPLYS
WITH THE REQUIREMENTS. FOR THERMAL ENERGY EFFICIENCY AS
STATED IN APPENDIX "J" OF THE STANDARD BUILDING CODE.
OWNER
OWNERS AGENT
DATE