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Home My WebLink AboutBLDG PERMIT #11654 Date: CITY OF CAPE CANAVERAL Tracldng# 6%.(?j®Z 3 BUILDING PERMIT APPLICATION Permit# (321)868-1222 City of Cape Canaveral Building Department -7510 N.Atlantic Ave.-Cape Canaveral,FL 32920 You may download this application: www.ciV-o_fcgRecanaveral.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 WBEN 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:_ Zoning classification: Flood Zone: Legal description of pro TwN: RNG: SEC: SUBD: BLK: LOT: PB: PG: Property Owner Name: LLC � Phone: Address: 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 Type of Square Const. Occu- FPL lines City Sewer #of #of. #of #of #of 'J Feet T anc currently available Valuation of work Building Type p y available to to serve Concrete/ stories dwel- bed- water (please under (lA, Classifica Asphalt ling rooms closets (Copy of Contract Required) indicate as roof VBserve this this Parkin, -tion g units applicable) etc) (B,111,113 property? property? Spaces etc.) Yes/No Yes/No Commercial SFR $ Townhouse $ Apartment $ ondominiu $ ther $ 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.):BW—�p Fax: Plumbing Contractor Name: Name of Company: Address: State License No.: Phone(office): Phone(cell/pager.): Fax: Mechanical Contractor Name: Name of Company: Address: State License No.: Phone(office): Phone(cell/pager.): Fax: Specialty/Other Contractor Name: Name of Company: Address: State License No.: Phone(office): Phone(cell/pager.): Fax: :,:1�'de.0,111.1'61131e`Huiklina Penz-iii Api,licsiiun RtN Ma., 16._'1 1? i • Y a Building Permit Application Checklist Notes Completed Permit Application Current code edition:FL Bldg.Code 2010(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 Maybe 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.Q. Sidewalk Impact Fee receipt If sidewalk exists on lot Recorded Warran 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: 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 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 summa 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 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 2010 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 six months 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* Contractor's Name: Contractor's Signature: Date: Site Address: For Notary use only: State of Florida,County of Brevard Sworn and subscribed before me this day of ,20____,by Printed name of Applicant Ewho produced identification: or is personally known to me. Seal: Signature-Notary Public At Large Ci:RI(19.))CI)Lfn]))15 Buil dry i'crmil Applii..urn Rei.DIaY 16,20 This form may be duplicated. Building Permit Application Checklist Notes Completed Permit Application Current code edition:Fl,Bldg.Code 2010(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 defend until C.O. Capital Expansion Impact Fee receipt Maybe deferred until C.Q. 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 ning 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 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 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 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 2010 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 six months 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* Contractor's Name: Contractor's Signature: Date: — "G Site Address: �3 �^ A w— For Notary use only: State of Florida ounty of Br vard Sworn and subscribed before me this day of u 20-15"by l rool a � Prin name of Applicant who produced identification: ��or is personally known to me. Seal: ---- "`r SUSAN,nJWsl•10 MY CQMMISSION#FF 114297 Signature- Public At Large -*' EXPIRES:April 17,2018 f11(ig.1)e `i1c �,TM1N*MKft4 YI6;2 l This form may be duplicated. RF„tA` s Date: CITY OF CAPE CANAVERAL Tracking# BUILDING PERMIT APPLICATION Permit# (321)868-1222 City of Cape Canaveral Building Department -7510 N.Atlantic Ave.-Cape Canaveral,FL 32920 You may download this application: www.cibLofcgpecanaveral.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: Zoning classification: Flood Zone: Legal description of property:TWN: RNG: SEC: SUBD: BLK: LOT: PB: PG: Property Owner Name: Phone: Address: Fee Simple Titleholder's Name(ifotberthan owner): Address: Bonding Company: Address: Mortgage Lender: Address: Type of Permit Brief description of work: Building Electrical Plumbing Mechanical Other Type of Square Const. occu- FPL lines City Sewer #of #of. #of #of #of JBuilding Feet Type pancy currently available Concrete/ stories dwel. bed. water Valuation ofwork (please under (IA, Classitica available to to serve Asphalt ling rooms closets (Copy of Contract Required) indicate as roof VB, -tion serve this this Parking units applicable) etc) (13,R1,R3 property? property? Spaces etc. Yes/No Yes/No Commercial $ SFR $ Townhouse $ Apartment $ ondomini $ ther I $ 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: Name of Company: Address: State License No.: - Phone(office): Phone(cell/pager.): Fax: Specialty/Other Contractor Name: Name of Company: Address: State License No.: Phone(office): Phone(cell/pager.): Fax: 6:1'!dg.i)cln.F<q]l15`Building Penrii Apiilicauun RcN.MaY 16.2012