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Home My WebLink AboutPermit #17-1576 - 191 Center Street Unit 101 - 10/17/17 .t City of Cape Canaveral Florida Building Permit PERMIT#17-1576 CUSTOMER#007420 PHONE: 321-868-1222 INSPECTIONS & FAX: 868-1247 PERMIT INFORMATION LOCATION INFORMATION Permit#: 17-1576 Issued:10/17/2017 Address:191 Center St Unit 101 Permit Type: MEC Cape Canaveral FL, 32920 Cost: 6843.00 Total Fees: 134.00 PERMIT EXPIRATION DATE:4/15/2018 Amount Paid: 134.00 Date Paid: 10/17/2017 r ONTRACTOR INFORMATION OWNER INFORMATION Name: Air American Service of Lake Park Inc Name: MILS Realty LLC Addr: 1310 S Killian Dr STe#109 Address:643 E 182 nd St Lake Mary, FL 33403- Bronx NY, 10458 Phone: (561)844-1902 Phone: State Lic#: CAC1814531 Local Lic#: APPLICATION FEES BP-Main: 100.00 BP-Plan: 0.00 After the Fact:0.00 BP-Surcharge:4.00 Fire Plan Review:0.00 Re Inspection Fee Paid:0.00 Plan Revision Fee:30.00 Plumbing: Mechanical: Date Plan Revision Fee Paid: Electrical: Sewer lmapct: Temp CO: Capital Expansion: Sewer Tap: Concurrency: INSPECTIONS(for complete list of required inspections refer to Hard Card) NOTE: Once an inspection is approved by an authorized inspector the permit expiration date is extended six (6) months from date of inspection. Permit Desc:A/C CHANGE OUT(5 TON) INSPECTION APPROVED BY: DATE: 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 STARTED. 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 PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 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 COMMENCEMENT. )01 / I/ - Sign & Date ` ^� AUTHORIZED SIGNATURE/ DATE ... ISSUED/DATE Print—► Ltli( 11—Q✓/,I PRINT NAME 110/17/ O17 10:53 AM i0 316--042`' T. a .Pi) LEFn nt y;: jr# Rmun L t0.O3 P i .1 ....„ (oPe 1°-Y'"F-- 2 4 Date: )0 1 I //I-+ CITY F CAPE CA VERAL Traddng# RECEIVED BUILDING PERMIT APPLICATION penitat# I --J — /5 :") (4- .. OCT 17 2017 (321)868-1222 City of Cape Canaveral Building Department -7510 N.Atlantic Ave -Cape Canaveral,FL 32920 You may download this application: wwwcitvofcapecanaveralorg. You may fax to: (321)868-1247. All applications must include the backside of this fonts. Important: Plesse 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 penult unless indicated otherwise by affidavit. I.D.may be required) Address of Job Site:/9/dt.iu- 5rit:7-- eir-vit-10i Zoning classification: Flood Zone: Legal description of property:TWN: RNO: SEC: SIJ13D: BLK: , LOT: PB: PG-. Property Owner Name: 4-7 / 1 $ /9 E,4/7)/ L Le_ Phone: Address: ‘ 9 3 Z- / ,i/j) Sr eri)-4/X 'a's' 10 vs-e Fcc Simple Titleholder's Name or other than owner): Address: Bonding Company: Address: Mortgage Lender: Address. 4 Type of Permit ' Brief description of work Building : Electrical Plumbing A Mechanical 6— 70-.1.1 '9i ey,o,)4',141'1,-/"'ULS. eJi-'i Other ,. . Type of sq... c.a. 0.. maws aty sewer #0 a of d of a of Net 4 Buildino,,,, Feet Type !whey car avalleele Concrete/ stories demi- had- water Valuation of work el under (IA, Classifies available la tn serve Ampler* ling roams deeds (r°10'°I c's'en“'R'luirtd) (please indicate as roof VB, -don serve this this pijodue wits etc) (8.1(1,123 Wailer"l property? Spates applicable) OW) Yes/NoYea/No — Commercial s (4.,1 ‘1). y - `-- SFR S Townhouse S Apartment Condominium S . Other $ . Architect/Engineer Name: Name of Company: Address: State License No.: Phone(office): Phone(cell/pager.): Fax: Primary Contractor Name: Name of Company: Address: State License No.: Phone(office): Phone(cell/pager): Fax: Electrical Contractor Name: Name of Company: Address: State License No.: Phone(office): Phone(cell/pager.): Fax: Plumbing Contractor Name: Name of Company: Address: State License No.: Phone(office): Phone(cell/pager.): _, _Fax: Mechanical Contractor Name: . Rilf,ack•tal P/c.4 Name of Company: ,91."- itir,e-eirie.1--44 Sl i^t...0,'.4 e Address: /39 S. A-iii 1...-t.k. P r-, titAz 7 i 44(I. "74Pit ,c1.- 33$,V-5 State License No.: <44C/%' S3/ Phone(office):,...al 4 i.w90,4-Phone(cell/pager.);1Z,/,‘,X,-‘47.9Fax.1?7,.."--ek:z Specialty/Other Contractor Name: Name of Company: Address: State License No.: Phone(office): Phone(cell/pager.): Fax: r Building Permit Application Checklist Notes 7 Completed Permit Application — Current code edition:FL Bldg.Code Fifth Edition(2014) Current survey showing all proposed construction and landscaping Check with Bldg.Dept.for setbacks 77 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 57,500 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: 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 t/ Mechanical Contractor Mechanical Contractor Roofing Contractor Roofing Contractor Swimming Pool Contractor Swimming Pool Contractor Gas Contractor Gas Contractor Specialty/Other Contractor Specialty/Other Contractor l- -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 inspection Electrical Load Calculations Plans must indicate person responsible for calculations Electrical Riser i All new service must be located underground J 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/Sprinkler./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 RIOR TO COMMENCEMENT* Applicant's Name: RAy /1404-D Pi C& Applicant's Signature: Date: —�$ —!7 Site Address: /,/ eg.ed I r Con• e4-.4.49pti-9'/ /��?2 920 For Notary use only: State of Florida,county of Brevarci Sworn and subscribed before me this / day of Or Ui'j� ,20l~/,by � /C inted name of Applicant who produced identification: or o<, is personally known to me. �, CHRISTINA WOW OD 6' Seal: IOJudly#F,FzDi1286x4 signature-Notary Public M Large •,, BoMnYdeECdXTOPhMrIuMEStSry = Public Undensriters r City of Cape Canaveral ANNUAL AUTHORIZATION FORM City of Cape Canaveral Building Department/110 Polk Ave,Cape Canaveral, FL 32920 Office:(321)868-1222/Fax:(321)868-1247 DATE: Cl (You may download this authorization form:www.citvofcapecanaveral.osz) CONTRACTORS&SUB-CONTRACTORS—PLEASE HAVE YOUR SIGNATURE NOTARIZED Company Name: rglr r4M ( ('9'i' S £"cJ/C . I, R7'y1'j11,,'vD P,G k ,hereby authorize the person(s)below 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(State License Number) e.467/6)/5/5-3/ This Authorization will be good for one calendar year and it will be the sole responsibility of the Contractor to inform the City of Cape Canaveral Building Department of any changes. It will be the sole responsibility of the Contractor to renew this form annually.The City of Cape Canaveral will not be held responsible for any permits leaving this office by any and all persons listed below while this document is in effect.The City of Cape Canaveral will not be held responsible for renewal of this document. 1. .r9n99>:S 64-/..*•0C 4. 2. Si/3 1'6 r 5. 3. Kt/h; V•T jC,t- 6. I.I3. M^ , i ATORY TO RELEASE PERMITS SIGNATURE OF LICENSE HOLDER:ra PRINTED NAME OF LICENSE HOLDER: Rl9 yrne9"ve) P,' For Notary Use Only: State of Florida,County of Brevard " / Sworn and subscribed before me this /(-day of�jGX✓ ,20/7,by K,/m,-„n Who produced identification: or Personally known to me CHRISTINA WOLD MY COMMISSION#FF 112634 EXPIRES:July 8,2018 Bonded Thru Notary Publir Underw' / Seal: Signature- • n.r..r.,,