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Home My WebLink AboutBLDG PERMIT #16-0324Date: L 29 /6 CITY OF CAPE CANAVERAL Tracking# O `C RECEIVED BUILDING PERMIT APPLICATION Permit # APR 2 9 2016 (321)868-1222 City of Cape Canaveral Building Department - P.O Box 326 - 110 Polk Avenue -Cape Canaveral, FL 32920 You may download this application: wwv..cityofca}jecanaveral.ors. You may fax to: (321)868-1247. All applications must include the backside of this form and 2 sets of supporting documents. 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. TD. may be required) Address of Job Site: /%/ eg ,,4Z/ 51� Zoning classification: Flood Zone: Legal description of property:. TWN: RNG: SEC: SUBD: BLK: LOT: PB: PG: Property Owner Name: i" l -i 1 S 9_P._ tl i4V LLC Phone: 2 / - Z/ 3Z - 4oSs Address: 6q 3 T /Y Z it 54- 13,-o /t K &V /O�fS-S1 Fee Simple Titleholder's Name (if other than owner): Address: Bonding Company: Address: Mortgage Lender: Address: Type of Permit Brief description of work: Building Electrical Plumbing Mechanical Other 1n z�, 1/ IV,, W -A Type of yp Square Const. Occu- FPI, lines City Sewer # of # of # of # of # of Building Feet Type pancy currently available Concrete/ stories dw•el- bed- Valuation of work water (please under (IA, Classifica available to to serve Asphalt ling rooms closets (Copy or Coninct Required) indicate roof VB, -tion serve this this Parking units State License No.: applicable) Phone (cell/pager.): etc) (B,RI,R3 property? property? Spaces p State License No.: Phone (office): Phone-(cell/pager.): Fax: etc:) Yes1No Yes/No Commercial SFR $ Townhouse $ Apartment $ Condominium, $ ther I I$ Architect/Engineer Name: Address: Name of Company: State License No.: Phone (office): Phone'(cell/pager.): Fax: Primary Contractor Name: Ve-v-, Address: 31?0/ SL✓ y7 Ale e - Z,- S / r✓ Name of Company: . iv 1-1 State License No.: 66L/5O946 2 Phone (o tce):'/0?- 366- Phone (cell/pager.): ySY-.f168 33/b Fax: 9Sy 1)Q?-yyZ Electrical Contractor Name: Address: Name of Company: State License No.: Phone (office): Phone. (cel Vpager.): Fax: .Plumbing Contractor Name: Address: Name of Company: State License No.: Phone (office): Phone (cell/pager.): Fax: Mechanical Contractor Name: Address: Name of Company: State License No.: Phone (office): Phone (cell/pager.): Fax: Specialty/Other Contractor Name: Address: Name.of Company: -- -- . - State License No.: Phone (office): Phone-(cell/pager.): Fax: B.uilding.Permit Application Checklist Notes 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 Notarized si ature — 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 appeoved site plain 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 Roofing Contractor Roofing Contractor Swimming Pool Contractor Swimming Pool Contractor Gas Contractor Gas Contractor Specialty/Other Contractor 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 inspection Electrical Load Calculations Plans must indicate person responsible for calculations Electrical Riser All new service must be located underground Plumbing Riser j 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'Draina a Survey Four sets of Fire Su ression/S rinkler.'A[arm 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 PRIOR TO COMMENCEMENT* Applicant's Name: 594t—,4 U//rte Applicant's Signature: Date: Z l Site Address: /g/ For Notary use only: State of Flo��ay y of Brev d r Sworn and subscribed before me thiof Yl , 20_ by Printed name of Applicant Izawho produced identification: or - is personally known to me. ';y•.,, KAREN HUTCHINSON Seal:=ra'= MYCOMMISSIaN6FF951009 EXPIRES: January 18, 2020 ry Signature - Notary u lie At. Large Bonded Thru Notary Public Underwriters Gated. 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: I% S� (You may download this authorization form: www.cityofcapecanave ra1.or) CONTRACTORS & SUB -CONTRACTORS — PLEASE HAVE YOUR SIGNATURE NOTARIZED m p a n y Name: jD9 A 6V9 Cow drvG.l-ON (, e✓ I, .0 &0 -V-' Oji 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) ef6 C /SD I t z' 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. 4—SekiJ t'0rje9-1A! 4. 2. 3. R1 I.D. IS MA TO MITS SIGNATURE OF LICENSE HOLDE _ PRINTED NAME OF LICENSE HOLDER:�cD�V� For Notary Use Only: State of Florida, County of BseveM Sworn and subscribed before me this //,:, day of JV1,� []ho produced identification: (Personally known to me or Seal: Signature - Notary Public At Large: 20 // � by 3"r, �mrftns Notary Public State of Florida John LaFayette My Commission FF 213823 a f� Expires 05!01!2019 2 nc11 Vi se-opoic r RGao s) pelt t'Z6c, (0m.10 063" x 5" ALUMINUM RETURNS 1" TRIM CAP RIVETS TO SECURE BACKS — TO CHANNEL LETTER RETURNS .125" Aluminum Backer — 150" Polycarb Faces w/Translucent — Vinyl Applied to Faces 1st Surface WHITE LEDS WALL VARIES IN THICKNESS & MATERIAL 5 Amps Max Load on 110-120v Circuit (ATTACHMENT) ALLTHREAD 3/8" x 5" Minimum OUTPUT. 12VDC POWER SUPPLY ENCLOSURE CLASS 2 POWER SUPPLY nnn—INPUT 110-120 VAC ~:LII�F �`ne Cattaver FFrA-fl-rFp ,CON t ✓iFVVIPL) S or�Ls i f' O n F) M 0 O ayleri y. of F!h,! enol L"", C ALL ELECTRICAL COMPONENTS THIS SIGN IS INTENDEDTO BE INSTALLED IN ACCORDANCE WITH THE UUUnderwriters REQUIREMENTS OF ARTICLE 600 OFTHE NATIONAL ELECTRIC CODE @ L Laboratories In C. AND/OR OTHER APPLICABLE LOCALCODES.THIS INCLUDES PROPER APPROVED GROUNDING AND BONDING OF THE SIGN. l