HomeMy WebLinkAboutBLDG PERMIT #5091
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! City of Cape Canaveral, Florida / I
[ ELECTRICAL PERMIT j5091 .
I PHONE: 321-868-1222 INSPECTIONS & FAX: 868-1247
I . .. PERMIT iNFORMATfoN] . LOCATION INFORMATION '1
, Permit #:5091 Issued: 6/08/2007 f Address: 7554 MAGNOLIA AV I
I Permit Type: ELECTRICAL I CAPE CANAVERAL, FL
Class of Work: REPAIR/REPLACE I Township: 24 Range: 37
Proposed Use: See specific use - residential i Lot(s): 1 Block: 44 Section: 23
Sq. Feet: Est. Value: I Book: 3 Page: 7
Cost: 3,500.00 Total Fees: 105.001 Subdivision: AVON BY THE SEA
Amount Paid: ~_ Date Paid: [Parcel Number: ~4 3723CG 44 1
CONTRACTOR INFORMATION I OWNER INFORMATION
Name: SCOTTS ELECTRIC INC I Name: TRSTE LLC TRUSTEE
Addr: 2984 MONICA TERR I Address: 501 E SOUTH ST STE B
KISSIMMEE, FL 34744 I ORLANDO, FL 32801
Phone: (4G:f)304*Oi{,?7 Lic: ER0010097 i Phone: 407-782-1069
Work Desc: ELECTRICAL REWIRE UNIT #2 AND ADDITIONAL RECEPTICLES IN UNIT #1
I APPUCA TION FEES
rE[ECTRrCA[=R.EPIA[fUNDER~ 70.00T PLANR.EVIEVV OVER 2K- 35.00 i
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I APPLICATION ACCEPTED BY,_ PLANS CHECKED BY, APPROVED BY, I
I NOTICE: THIS PE.R....M......IT....B... E....C...O.......M.... E....S....NU.LL AND VO..I..D.........I...F.. WORK OR CONSTRUCTION AUTHORIZED IS N.O. .....T.... C.....OMMENCED WITHIN 6 MONTHS, OR I
IF CONSTRUCTION OR WORK IS SljSPENDE[). OR ABANDONED FOR A PERIOD OF 6 MONTHS AT ANY TIME AFTER WORK IS STARTED I
[i I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS DOCUMENT AND KNOW THE SAME TO BE TRUE ANDCORRECT. ALL PROVISIONS OF LAWS AND I
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
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
[ COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS I
I TO YOUR PROPERTY IF YOU INTEND Tn OBTAIN FINANCING, CONSULT WITH I
I :OUR LEN,.. .0. ER OR... ANY ATTORNEY BEFORE RECORDING.. YOUR NOTICE OF I
[-COMMENCEMENT.
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[ ~ ISSUED ~lDA TE ;:fUfHO~ED SIGNATURE/DATE I
01 0,:,11 'O? n:2BO:3201 PUJ PUJ 2 $105000
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Jun 05 07 08:42a CREATIVE REMODELING 4078259316
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Dat", ;7'2c/. 0'7 CITY OF CAPE CANAVERAL "",.....D7.cxo/3 I
BUILDING PERMIT APPLICATION PermiU 5 0 91
(321) 868-1222.
~ \J ~ ~ S City of Cape Canaveral Building Department 105 Polk Ave. Cape Canaveral, FL 32920
You may download this application: w\n\'. m;:llorid".cclln: eili}!;., You may fax to: (321) 868-1247. All applicalions must include the
backside of this fonn. Important Please complete the checklist OD the back of this form and provide other docuIJ:1entation as indicated
on the check1isl 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 .s~ for the bui~9IDg permit, unl~ indicaled otherwise by affidavit. I.D. may be required)
Address of Job Site: /157S1' ..11I #-"'--;;//"".r.).!/,~~;;' ~:;-;:-. Zoning classification: _ Flood Zone: -
Legal descriptionofprop~TWN: ,~~i~SEC;-----::SUBD: BLK:_LOT:_PB:_PG:-
Property Owner Name..; ^A.~"4~,' ?t::..;.; "_/;" hLC., ~ . Phone: l/'/' 7' - 7;:: (.'.:-fLj(.. "i
Address' I'?'" '/. .-1-"/",-,,, , , .0.- ,', .. . --. . ,."'/ .'" ';7'::;"', ','
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Fee Simple itleholder's Name (ifotlleTthmlC'w.....): Address:
Bonding Company: Address:
Mortgage Lender: Address:
-V Type of Permit Brief description of work:
/Buildin
:/ Electrical 'r:"2~/;C('- hoP"~ ;:!7 z..
Plumbin
Mechanical
Other
Type of Coost. Occ- FPL Unes Oty Sewer WID thi9 I
~ Building :DtBre Typ(lA,e npmlCY C:lUTeUtty avaUsble I structure fIlor lor tlO( itar VaJulldonofwol'k
(PI ee Gronp available tD to !letVe hove built-in storirs dwd- bed- wsfer
. dj';"Sc under VB, (B,Rl. serve this this ""~ IIl'l:; rooms closets
m calc: as roof etc) en:.) ft"""" ...- '
applicable) proP~..J' property? llppllIlDl:es? wuts
ro~, . YeslNo YeslNo Yes/No
~mmercla1
SFR $
ownhouse $
~partment $
Condominimr $
'/' Other /<1"" 9:
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A.."..~t,,~mngm. N -:, ~ -c.;(? ".:-
~p~~"vc eer.. aIDe:
Address: Name, of CoUlpliIiY:
State License No . -. . .
Primarv ", Phone (office): Phone [cell/pager.): F" ~.
.. Contractor Name: ax.
Addcess:--- Name of Company:
State License No .. Ph (ffi)
.. one 0 ce" Ph
E . . one (ceU/pager)'
lectrical COAf:racf:or Name' ~ " " 1 r _. . .. . Fax:
Address: ',;-9fj'il ~ '""NI:::;~ ~~<:,,~.e /{,:,/',['NameofCompany: ..JC.dTr DL. '/
S' ,,",,,~ "-' . -~ P/G -r':. _' " Hu
tate License No.: e::.e. (jOIOO'l7Phone (office): Pbo .
Phunbing Conlractor Name: ne (celllpager.): Itl! 1:301- 0<19'7 Fax:
Address: Name of Company:
State License No "
.. Phone (office): Phone (celli ).
M h "ca1 C pager. . Fax'
ec am ontractor Name" .
I Add-res.s:' Name of Company:
State License No . ." . -
." Phone (office): Phone (ceW' ~"'"
SpeCIalty/Other Conttactor Name: pager.). Fax:
Address: Name of Company:
State License No.: Pho'
ne (office). Phone "'celJlp ."'\r
...._..~' ager.;,. Fax:
G:\Brdg.Dept.Forms\BPAl'PUCATION Rev. July 20. 2006 l'~'.~"',,~,. "~...
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Jun 05 07 08:43<:1 CREATIVE REMODELING 4078259316 po3
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Notes
V Building Permit Application Checklist Current code edition: FL Bldg. Code 20M (as revised)
Comnleted PennitApplication . . Cbeck with Bldg. Dept. ftJrsetbacks
Current survey soowmg aU nroposed constru~on and landscaping [f owner is "Cling as conttllctor
Notarized sil!l1llture OwnerlBuuder AffidaVIt May be deferred until C.O. UIl1css job is remodeling
Sewer Impact Fee receipt May be deferred unlil C.O.
County Imoael Fee :receint Maybe deferred \Illtll C,O.
Capital Expansion Impact Fee :receipt IfsidewBlk exists on lot
Sidewalk Impact Fee reciint bin 0\Ia' $5,000 fur MecbanicaI clrang\> out
Recorded Wammtv Deed / Proof of Owners
CODY ofRecMded Notice of Commencen::ent (over $2,500) Record will be kept on file after initial submillal
Current Worker's Como. Policy J ExemptIon For all work visible fium Public Right-Of-WBY
Community Anneanmce BoardADilroval For all ncwamstrDdion of fuur umlS or more
PlanninJ!: and Zoom,!!; Board Site Plan Approval For all new c:oustrueIion DOt part of approved site plan
Concummcy Forms Record will be kept on file after initial submiII:a1
Primmy Contractor's State License .. Record will be kept on fileafter' initial submittal
Subcontractor's AutbonzatJons: Notify Building DcpartmeIl1 of conttllClUl" changes
Slate License Plumbing Cootractor
Plumbing Contractor
Electrical Contractor Electrical Contractor
Mechanical Contractor Mechanical Contractor
Roolin!! Contractor Roofing Contractor .
Swimmine Pool Contractor Swimminl! Pool Contractor
Gas Contractor Gas Contractor
Specialty/Other Contractor Specialty/Other Contractor PerF.B.C.l04
Construction Drawings: PerF.B.C.I04
Two sets of sealed construction drawings (three sets if commercial)
Electrical Load Calculations Plan511l11St indicaw pcrsmI responsible fOT calculaliOJl5
Electrical Riser All new service IDLI5l: be Jocau:d underground
Plumbinl!' Riser Plaus most indi/.':8te per.;vu ~"bk furdesign
Ale layout Plans II1IZSt indicate person n:spCIDSI"bll: fur design
Two sets ofEnerev Calculations Plans.amst indicare peIS'OII JeSpllIlsibfe ror calculations
Lot Drainage Survey Requm:s FIre])cpt. approllBl prior to i.sst1am:e ofpennil
Four sets ofFiIe Suppn:ssionlSorinklerlAlann svecifications
Pool Barrier Reauirement Form lsilmed) Pool pennie vn11not be isst.;:d williUb1: blmita
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 warlc 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 i:tpplicauon is the
Florida Building Code 2004 Edition. I understand that all permits require inspections as indicated. This permit
application is valid fOf six months from date of submission. By signing, applicant affums 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.
Ap li ant' N ' <.: ~ ;;" 'H' · li ~" ~~ rJ~
u P 1C S arne. .---/j,;;v / /~.::' (;- I'??,~ Plpp can s :SIgna~' ;V"i I). ..x;. .__ ___
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Date: :_") ,-. :.;-, --j -....<:...., \ ,~? "Ie:.;- C/ ~ " /J
Site Address: /j':;r.1j .t-z-/'~ 7~-''-
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For Notary use only: State of Florida, County of Brevard
Sworn and subscribed before me this .- day of ~:">J~ r.~ ~. , 20 :-" if . by ""~' .~"", 'r, -:>i-., ')
~.;. " ,-_/ ~~ '.-"". .
r--I who produced identification: Printed nJtJ'Qe of Applicant
rl or
L.:.0 is personally knoWn to me.
Seal: - .. .- , . .....-.
Signanire - NO1m)' Publil; At I.arge
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G:\Bldg.Depl:.Forms\BP APPLICATION Rev. July 20. 200 .lm~ DEBI57: This funn Jl1Jly be duplicated.
~. .;: Nola . RElT
~~ oiMv ('~_~btlC - Stare of FJnn..t.
r;::'~~",- ~ -.mJfl~lOn EXpires Ma ~~
""'IJUI.U' COIllJnissio Y 16, 2009
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Jun 05 07 08:43a CREATIVE REMODELING 4078259316 4
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CITY OF CAPE CANAVERAL
. AUTHORIZATION FORM
,....
City of Cape Canaveral Building Department 105 Polk Ave. Cllpe Canaveral, FL 32920
(321) 868-1222
(You may download this authorization: \,'\'/\Uiwf1orida.com:cJnc. You may fax to: (321) 868-1247,
Date: 5'::? il ' c; 7 Permit #:
CONTRACTORS AND SUBCONTRACTORS - PLEASE HA VB YOUR SIGNATURE
NOTARIZED AND SUBMIT THIS FORM WITH THE PERMIT APPLICATION.
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I, '.) <- (: -rr !/ (,' !-'I-i ,;; V , herebyauthonze ,b~ /i7' /r:.--. rfi7'f: e L /
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(Slate LicCDSI.': Holder's Name - PLEASE PRINT) (Au1horized Person - PLEASE PRINT)
to obtain a pennit on my behalf under my state license as issued by the Department of
Business and Professional Regulation, Constmction Industry Licensing Board (:;;:/2 Cc;:; .(., (, ) '1 ,
(State License Number)
for the job site described below.
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I...J Type of Permit J /~//'7! ~/_/'d':'~ ~/ /
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Building , Name of Property Owne-r
PI b. ~ /. /?
urn mg "'r-: -- ,./lV /
,/ .~ -< f/ .
Electrical ,/. /' Ij /4l-;'.t L C ,,;/ /;{;:/
Mechanical Address of Job Site
'-,
R fin /.
.00 g ;' "i /~
S ~ " /!. ....::.~.: ; .~, .~;!..-1-:'. .: ~ /: /
wunmlOg Pool'~ ~Lt -~:'f/;I I.. i //
_ _ __ _...._mn........ _ __ -- "';,-ff : \ ' ";. ~:':'--L---"'-.-
Specialty Stmcture Signature of Lkense Holder
, Other - Specify:~~~
,For Notary use ~nly: State of Florida, County of Brevard
Sworn and subscnbed before me this ;" '-: day of -,I. ,.,.' 20" .~ ".
. -, r. ...> ,by , '. ','- "
8 who produced identification: ' ----J ~ . ~~~~f A~~I~~~ n :..0 (";
_ . or
'= IS personally known to me.
Seal:
Signature - Notary Public At Large
, G:\Bldg.DepLForrns\Authorization Form
This form may be dupliCllted.
Address: ~l ~s~f;11(JC:Y21.f14~ (Z~ "- uf'
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BUILDING PERMIT FEES:
Building Permit per square footage:............................................................
Total Sq. Ft. (Living Area):
Total Sq. Ft. (Enclosed Area):
Building Permit based on valuation:......:.?~./~.~................................. Vi)
Total~0ving Area): r ~. (;yc:] ~. f)D
~~' ~/ /0,,0 J
a .. "t.Lt''lf' ( a,.;) K"/- ,~
Total Sq. Ft. (Enc osed Area): 7t/"D 0
B uil ding P ermi t miscellaneous:..............................................:......................
Total Sq. Ft. (Living Area):
Total Sq. Ft. (Enclosed Area):
ElectricaL......................................................................:..................................... .
Plum bing......................................................................................:................:.....
vlechanical........................................................................................... ................
3uilding Permit Plan Check Fee....:2'O/.~.............................................. '3 -- -
.S,DU
=iire Dept. Plan Check Fee................. ......... .................... ...... ...... ....... ..... ..........
ladon Trust Fund: sq. footage .................................
-, F .
_oncurrency Management ee......................... ......................... ................ .......
:::a pital Expansion Fee..................................... ...................... .............................
Total Building Permit Fees:...... ID 5^, oD
;;EWER PERMIT FEES:
Sevier Impact Fee.....................................................................................
Sewer Tap Fee.......... ~................................................................................
Total Sewer Permit Fees.. .......u.
By: ~. Date: 6--7-01
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