HomeMy WebLinkAboutBLDG PERMIT #7052Permit #: 7052
Permit Type:
Class of Work:
Proposed Use:
Sq. Feet:
Cost:
Amount Paid:
City of Cape Canaveral, Florida
MECHANICAL PERMIT
PHONE: 321-868-1222
MECHANICAL
REPAIR/REPLACE
BUSINESS
Est. Value:
500.00 Total Fees:
Date Paid:
Name: FLORIDA MASTERTEMP, INC.
Addr: 3475 N HIGHWAY.1, UNIT 1
COCOA, FL 32926
Phone: (321)639-3166 Lic: CAC 1816171
Work Desc: REARRANGE RETURN DU
- REP/ALT UNDER
APPLICATION ACCEPTED BY:
45
INSPECTIONS & FAX: 868-1247
rii-.> I ro
7052
Address: 166 CENTER ST
CAPE CANAVERAL, FL
Township: 24 Range: 37
Lot(s): Block: Section: 23
Book: Page:
Subdivision: TECH VEST
Parcel Number: 24 3723JI E1
Name: DELUCIA, JOSEPH L
Address: 650 HERITAGE HILLS UNIT A
SOMERS, NY 10589
Phone: 386-446-7722
HROUGH FIREWALL
PLANS CHECKED BY: APPROVED BY:
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 6 MONTHS, OR
IF CONSTRUCTION OR WORK IS SUSPENDED. OR ABANDONED FOR A PERIOD OF 6 MONTHS AT ANY TIME AFTER WORK IS STARTFD
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS DOCUMENT AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING
THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR ANY ATTORNEY BEFORE RECORDING YOUR NOTICE OF
ISSUED BY/DATE
;>
AUTHORIZED SIGNATURE/DATE
PRINTED NAME: �%�'/�L�(fi"S / �=� J✓j'!3%�
Da.. CITY OF CAPE CANAVERAL Tracking #
io— 027
BUILDING PERMIT APPLICATION Permit # t
(321) 868-1222
City of Cape Canaveral Building Department 7510 N. Atlantic Ave. Cape Canaveral, FL 32920
You may download this application: A,-ww.cityofcQecanaveral.org. You may fax to: (321) 868-1247. All applications must include the
backside of this form. Important: Please complete the checklist on the back of this form and provide other documentation as indicated
on the checklist. A copy of contract may be required. Application packages will not be accepted unless complete.
APPLICANT WILL BE CALLED WHEN PERMIT IS READY.
(Contractor/Owner-Builder is required to sign for the building permit, unless indicated otherwise by affidavit. I.D. may be required)
Address of Job Site: G n 4 e y- _5'4. Zoning classification: Flood Zone:
Legal description of pro pert �: TWN: RNG: SEC: SUED: ELK: LOT: PB: PG:
Property Owner Name: ` i t c LLQ„ Phone: 32 -i ?3 y q 7 cl
Address: j 2 y 5t-, Up'% X A11e01A)C Oe S i
Fee Simple Titleholder's Name (if other than owner): Address:
Bonding Company: Address:
Mortgage Lender: Address:
A Type of Permit Brief description of work:
Building
Electrical
Plumbing
Mechanicale c {
Other
Type of
1' Building
g
(please
indicate as
pplicable)
Const. Occ-
Square Type upancy
Feet (IA, Group
under VB, (B,Rl,
roof etc) etc.property?
FPL lines
currently
available to
serve this
Yes/No
City Sewer
available
to serve
this
ro ert Y'
P P
Yes/No
Will this
structure
have built-in
gas
appliances? liances,
Yes/leo
# of # of
stories dwel-
ling
units
# of # of
bed- water
rooms closets
Valuation of work
Vicommercial
Name of Company:
State License No.:
Phone (office):
Phone (cell/pager.):
$ 0-0 Y -M)
SFR
Name of Company:
State License No.:
Phone (office):
Phone (cell/pager.):
$
Townhouse
Name of Company:
State License No.:
Phone (office):
Phone (cell/pager.):
$
Apartment
e_ s E %e r j.,c
t 41
Name of Company: '46
(, - t . 3,) 9 �2 G
r
State License No.: Q 6
Phone (office): 3.QP- (03 c
- 11, Phone (cell/pager.):
$
Condominiu
Name of Company:
State License No.:
Phone (office):
Phone (cell/pager.):
$
ther
$
Architect/Engineer Name:
Address:
Name of Company:
State License No.:
Phone (office):
Phone (cell/pager.):
Fax:
Primary Contractor Name:
Address:
Name of Company:
State License No.:
Phone (office):
Phone (cell/pager.):
Fax:
Electrical Contractor Name:
Address:
Name of Company:
State License No.:
Phone (office):
Phone (cell/pager.):
Fax:
Plumbing Contractor Name:
Address:
Name of Company:
State License No.:
Phone (office):
Phone (cell/pager.):
Fax:
Mechanical Contractor Name: ; rva
Address: At c U
e_ s E %e r j.,c
t 41
Name of Company: '46
(, - t . 3,) 9 �2 G
r
State License No.: Q 6
Phone (office): 3.QP- (03 c
- 11, Phone (cell/pager.):
Fax: 321- ;2Y-73
Specialty/Other Contractor Name:
Address:
Name of Company:
State License No.:
Phone (office):
Phone (cell/pager.):
Fax:
G:\Bldg.Dept.Forms\Building Pennit Application Rev. August 20, 2008
Building Permit Application Checklist
Notes
Completed Permit Application
Current code edition: FL Bldg. Code 2007 (as revised)
Current survey showing all proposed construction and landscaping
Check with Bldg. Dept. for setbacks
Notarized 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 file after initial submittal
Subcontractor's Authorizations:
State License
Record will be kept on file after initial submittal
Notify Building Department of contractor changes
Plumbing Contractor Plumbing Contractor
Electrical Contractor Electrical Contractor
Mechanical Contractor Mechanical Contractor
RoofingContractor Roofin Contractor
Swimming Pool Contractor Swimming Pool Contractor
Gas Contractor Gas Contractor
Specialty/Other Contractor J 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.
Electrical Load Calculations
Plans must indicate person responsible for calculations
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 Su ression/S rinkler/Alarmspecifications
Requires Fire Dept. approval prior to issuance of pemut
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 2007 Edition. I understand that all permits require inspections as iodic,,
application is valid for six months from date of submission. By sianina. annlicant affirms that
correct and that he/she
ited. This permit
all above is true and
an authorized agent of the Contractor/Owner and has the authority to apply for this permit.
Applicant's Name:'I 6 nvuc, Applicant's Signature:
Date:16(l/ —
Site Address:
For Notary use only: State of Florida, County of Brevard
Sworn and subscribed before me this J , l ` day of Vt,k , 20 ) , by 01 -Q 5 L rr r ct 4
Printed name of Applicant
who produced identification: _ or
is personally known O E�IEM. RYHOWVPubkof FlordMft
• vAsg 26.2011Seal: C0706316°F �.` AW
G:\B1dg.Dept.Forms\ Building Permit Applicatior. Rev. December 17, 2004
',/�nzt Signature n, Z,� '
e( Notary Public ge
This form may be duplicated.
Feb 16 2010 7:22PM FLORIDn MRSTERTEMP 3216382473
c;-
Da�uf = CITY OF CAPE CANAVERAL
BUILDING PERMIT APPLICATION
Tracking
Permit_
p.2
(321) 868-1222
Cjty of Cape Canaveral Building Depeatnent 7510N. Atlantic Ave. Cape CanMv=al, PL 32920
You may download this application: you may fax to: (321) 668-1241. All application® must include the
bacbide of this form, Important: Flease complate the cheekhst on the, back of this form and provide other documentation as indicated
on the checklist, A copy of contract may be required. Application packages will not be accepted unless complete.
ApPLZCANi' WILT. BE CALLED WHEN PERMIT Is R•BADY.
(Contractor/Owner-Buildar is required to sign for the building permit, unless indicated othmwise by affidavit. I.D. 'nay be required)
Address of Job Site:/(a jQ e e� err S4, Zoning classification' Flood Zone:
Legal description of pro perty+' TWN: RN G: __ SEC: S0BD: stat LM ra: R 2 t — —18 - 1'Q
PropeFry Owner Name,
hone: St' i
Address:
Fee Simple Titleholders Name (9f other thm owner): tiaurnnd:
Bonding Company: Address:
Mortgage. Lender: Address:
Cr;\8idg,Dept,Forme�9uilding Peamit Appliaattan Rev. Auau9t 20, X006
'I�rpe of
9quere
const. Oce- Frx.lines city sewer
Type upsatcy currently svaiiaNM
Will tbie
structure
40(of
# ar
t� of Valuatlou of work
Building
Feet
(IA, Group xv.H.h10to to serve
havebullt-!n
varlm
dw&
uni
hp&
eoartl:
1"fer
class"'
(please
under
VB, (B.M. serve this this
gat
atilt
indiaatem
roof
tic) etv,) property7 prop�YY
s► BastcesY
pp
YC&WQ Yes/No
Yes No
_Opwticable)
I 00
VlConmercial
STO
$
SFR
S
Townhouse
S
astmettt
ConBvminiu
�
er
Cr;\8idg,Dept,Forme�9uilding Peamit Appliaattan Rev. Auau9t 20, X006
Address:
BUILDING PERMIT FEES:
Building Permit per square footage: .............................................................
Total Sq. Ft. (Living Area):
Total Sq. Ft. (Enclosed Area):
Building Permit based on valuation: .................. ..� .r .....................
Total Sq. Ft. (Living Area): c = 1Y = c)
Total Sq. Ft. (Enclosed Area):
Building Permit miscellaneous: .....................................................................
Total Sq. Ft. (Living Area):,
Total Sq. Ft. (Enclosed Area):,
Electrical..........................................:......................................
Plumbing.......................................................................:.............:................:.....
Mechanical.............................................................................................:............
Building Permit Plan Check Fee..................................................................
FireDept. Plan Check Fee................................................................................
Radon Trust Fund: sq. footage
Concurrency Management Fee...........................................................::............
CapitalExpansion Fee..................:.....................................................................
Total Building Permit Fees:......
SEWER PERMIT FEES:
Sewer-Impact Fee.....................................................................................
SewerTap Fee.......................................................................................
Tn+nl ClatATaYPaVm;+ V -
t
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(You may download this authorization: w%vw.myflorida.comlcgp . You may fax to: (321) 868-1247.
Date: 3-3-/(p
Permit #: p 0 2
CONTRACTORS AND SUBCONTRACTORS - PLEASE HAVE YOUR SIGNATURE
NOTARIZED AND SUBMIT THIS FORM WITH THE PERMIT APPLICATION.
Company Name: -\- t 0 �-'.
I, 6c3 F � , hereby authorize C� 4 i (,1 a Ct —
(State License Holder's Name — PLEASE PRINT) (Authored Person — PLEASE PRINT)
to obtain a permit on my behalf under my state license as issued by the Department of
Business and Professional Regulation, Construction Industry Licensing Board ,A C,-1,) (1- I ,
(State License Number)
for the job site described below.
* For blanket authorization, do not complete.
Name of Property Owner
Address of Job Site
Signa a of License der
For Notary use only: State of Florida, County of Brevard
Sworn and subscribed before me this ? ' day of 4 r). Ck r C.�., , 20 10, by
who produced identification:
is personally known to me.
e�xx. HOPE M. PERRY
Seal: - State of JW RuSC 3 DD 70°° o ...q
G:\Bldg.Dept.Fonns\Au oi3 ation orm
W 4P 4P
or
Name of Applicant
s
-"
Sip—allure,- Notary Pu
t Large
This form may be duplicated.
Type of Permit
Building
Plumbing
Electrical
Mechanical
Roofing
Swimming Pool
Specialty Structure
Other – Specify:
Name of Property Owner
Address of Job Site
Signa a of License der
For Notary use only: State of Florida, County of Brevard
Sworn and subscribed before me this ? ' day of 4 r). Ck r C.�., , 20 10, by
who produced identification:
is personally known to me.
e�xx. HOPE M. PERRY
Seal: - State of JW RuSC 3 DD 70°° o ...q
G:\Bldg.Dept.Fonns\Au oi3 ation orm
W 4P 4P
or
Name of Applicant
s
-"
Sip—allure,- Notary Pu
t Large
This form may be duplicated.