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HomeMy WebLinkAboutBLDG PERMIT #12564Date ,D CITY OF CAPE CANAVERAL Tracking# 15---0609y- AUG 2 7 2015 BUILDING PERMIT APPLICATION Permit # / ,.256 f (321)868-1222 Y-e - I 31a6 City of Cape Canaveral Building Department - P.O. Box 326 - 110 Polk Ave. - Cape Canaveral, FL 32920 You may download this application: www.cityofcapecanaveral.org. You may fax to: (321)868-1247. All applications must include the backside of this form & 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 the contract may be required. Application packages will not be accepted unless complete. APPLICANT WILL BE CALLED WHEN PERMIT IS READY (Contractor/Owner-Build is require to sign for the building permit, unless indicated otherwise by affidavit. I.D. may be required) Address of Job Site: I -1- VN Cne_ Zoning classification: Flood Zone: X Legal description of pro : TWN: 7,4 RNG: 3 T SEC: L 9 SUBD: BLK: LOT: h . e PB: t PG: 7 ,. Property Ownerlame: Phone: 1 `A.e COI F1 3 f Address: Address: (-kw aacbar Fee Simple Titleholder's Name (if other than owner). Bonding Company: t%L Mortgage Lender: �( Address: Address: .J Type of Permit Brief description of work: / Building aiy1'. rcri,i\'t ► e,5 erxce Electrical P Plumbing M Mechanical Other ' Type of Building g 'please udicatcas applicable) square 9 Feet under roof Const. Type (IA, VB, etc) Occu- panty Classifies -tion (B,RI,R3 etc.) FPL lines currently available to serve this property? Yes/No City Sewer available to serve this property? Yes/No # of Concrete! Asphalt Parking Spaces # of stories # of dwel- ling units # of bed- bed - rooms # of water closets Valuation of work (COP' of Contract Required) Commercial .11 $ itSFR , `` `I C5 1 I S Townhouse $ Apartment $ Condominium S Other S Architect/Engineer Name: Name of Company: Novo `C1 Be-C 3,5 k.A c P. r Address: ry 363 J,.) ran c lomcb r- I 3 ZaZb State License No.: b • Phone (office): Phone (cell/pager.): (3?1 -'�)( 2 Fax: Primary Contractor Name: Cho,(, Gf� e SS« jV ► Name of Company: er `/ Cc c 3tcuc A i c ' Address: Z.b(4O Qf 1iS iCe__ l-itr.1e Melbousnw_ Vi LI State License No.:(((. VI 7 Phone (office): Phone (cell/pager.) 0 /II 24i8 - t -I 15Fax: Electrical Contracto Name: hn y r1e.v. Q Name of Company: eS* DDE T<it., Of Ne I Address: %16 4 '‘ YQ\rn a>) Fl 3 Z Q Q _1 t\- State License No.: EC,130 VI Phone (office): Phone (cell/pager.):071) Zgl-17 3Fax: Plumbing Contractor Name: Name of Company: tetn \-\err' o 71uf ; �13 ` w Address: LI AO Ol>J e i ovc ci .3 4 State License No.:� (..85 1 Phone (office): Phone (cell/pager.): Fax: Mechanical Contra r Name: Name of Company. �CxlillCJ► Address:571' �V �C l UC Q,� OV C e— F► 3 z 3 State License No.: t Phone (office): Phone (cell/pager.):�3t in/8/OFax: Specialty/Other Contractor Name: j Name of Company: Address: State License No.: Phone (office): Phone (cell/pager.): Fax: C7' Bldg.Dept.Fo ms\Building Pennit Application Revised 6:2g/15 4 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 XNotarized 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 State License Authorizations: 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 Roofmg 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/Sprinider/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 ' ' 0 ' T ! . OMMENCEMENT* Contractor's Name: CNN Ci.V Contractor's Signature: Date: I`J For Notary use only: State of Flori Sworn and subscribed before me this Rch6"--- produced identification: is personally kno ' ` 4 BRANDY DENISE TORRES MY COMMISSION #FF084703 ',d,,°' EXPIRES January 21. 2018 •t07) 398-0153 FloridallotaryService.com • Site Address: 1 ZI Oo \CX1_ linty of B1vard day of U Seal: ature - Notary Public At Large G:\Bidg.Dept.Fonns\ Building Permit Application Revised 6/29/I5 This form may be duplicated. I a Architect/Engineer Name: Name of Company: - Address: I trj - State License No.: Phone (office): Phone (cell/pager.): Fax: Primary Contractor Name: s Name of Company: 1Z r CA. rUC1i� Address: z 40 B� Ksl��rL iic1e , 2 housrne. �� State License No.: Phone (office): Phone (cell/pager.) i - 6 Fax: Electrical ContActo ame: : iy���TC j Name of ComLpager.):(3iZ Address: l 36 n�nl Q� Fi 3 2 g 6 State License No.: Phone office): PhoneFax: Plumbing Contractor Name: ;___ Name of Com any: ��r�1pe� i7lllmtln► ` ��� Address: 4 vq�J 0 � � Ct1 1 —s— �--�— � q� 3 `► State License No.: Phone (office): Phone (cell/pager.): Fax: V Mechanical Contra r 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: Bldg .D;pt.Foin s building I' nnii Application i:t•r:• NOTICE OF COMMENCEMENT PERMIT NO. STATE OF FLORIDA COUNTY OF BREVARD TAX FOLIO NO. THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Description of property: egal desc • tion of the props and street address if available) ( - - a Lr 1 Z-1 ( Wm. Lc G Q,\ 2M1 (()1 • L 2. General description ofimprovethent: x t>p' 'anCI Zes c\Cr_ 3. Owner information: a) Name and address: 5 .-te cl �o.1.1 C. I-100 ACK‘c_ li ,ce- CCYY>, r_ MA ri no b) Interest in property: c) Name and address of fee simple titleholder (if other than owner): N I I\ 4. Contractor (Name and address T 'r �k�'4 f `r r,5 C >G� ,f &AO Cc�Y�4 e. ' \cue Me 5. Surety: N a) Name and address: b) Amount of bond: 6. Lender (Name and address): 1.1 ' CIO Ll -371-L(Q3 -se 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13 (1) (a) (7)., Florida Statutes (Name and address): 8. In addition to himself, Owner designates of to receive a copy of the Lienor Notice as provided in Section 713.13 (1) (b), Florida Statutes. 9. Expiration of date of notice on commencement (the expiration date is 1 year from the date of recording unless a different date is specified): WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF C• NCEMENT MU: - BE ORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OB r FIN C i G, CON yN -I YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR N e TI OF CO CFN 2015166008, OR BK 7435 PAGE 306. Recorded 08/20/2015 at 02:16 PM, Scott Ellis, Clerk of Courts, 8revard County tiPgs1 STATE OF FLORIDA COUNTY OF BREVARD The foregoing instrument was acknowledged before me this & day of "./ec person) as 011ikt - PR 0� . (type of authority eg: officer, trus ee, attorney in (name of party on behalf of whom instrument was executed) M ICHELLE MCMICHAEL Notary Public • Stets of Florida My Comm. Expires Nov 2, 2018 rr, , r Commission I FF 187051 ''' Bonded through National Notary Assn Signature of O" er or Owner's Authorized Officer/Director/Partner/manager `Fg[2)tiT Signatory's Title/Office , 201_5-by itydGC f ,Lt!-� (name of fact) for 9' 4 Rtf°4— Signature of Notary Print, Type or Stamp Commissioned Name of Notary Public Commission Number Personally Known V or Produced Identification Verification Pursuant to Srrtion 97 525 Florida Standri Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of Signature of Natural Person rgung BUILDING PERMIT FEES Address: % 27 oAK u ,JE CONSTRUCTION TYPE SO. FT. COST *MODIFIER VALUE 1&2 FAM. CONDITIONED: T i 4 . % 3 DD c 4 12 66' .91 $ 30 $) 45 1&2 FAM. UNCONDITIONED: .91 $ OTHER: .91 $ OTHER: .91 $ OTHER: .91 $ `/ TOTAL CONSTRUCTION VALUE BASED ON ICC VALUATION CHART $ 30g, 4.7 TOTAL CONSTRUCTION VALUE BASED ON CONTRACTOR ESTIMATE: $ 3013',057 _cook 2° t51 = 5'4,5 zo9 IcS : + 8 3(0 BUILDING PERMIT FEE: $ 4 it-{ o l GROSS SQUARE FOOTAGE: 3 0Og BUILDING PLAN REVIEW FEE: (1/2 THE BUILDING PERMIT FEE) $ 70o.S0 ELECTRICAL: $ / 90 PLUMBING: ( 2) x G o $ I ZO MECHANICAL: FIRE DEPT. PLAN REVIEW FEE: $ BUILDING PERMIT SURCHARGE: (GREATER OF $4.00 OR 3% OF TOTAL FEE) $ 7 (' 0) 0 CONCURRENCY MANAGEMENT FEE: Calculated By: $ /00 TOTAL FEE DUE: $ 25498.4D Date: — 2V/5 Modifier is a regional cost modifier set by the International Code Council SWA•24z Date: CITY OF CAPE CANAVERAL Capital Expansion Trust Fund Impact Fees & Sewer Impact Fees Project Name: S F' Permit Number: TZtic12-tP G [' - e'A p c)q- Property Owner: St#NEgo?PetLL- Address of Job Site: t _71 CONSTRUCTION CLASSIFICATION: Residential: Non -Residential: Calculation of Capital Expansion Impact Fees (fund 302) (Prepared by the Building Department) PARKS & RECREATION: $ 5 l 55 LIBRARY: $ . O 3 GENERAL GOVERNMENT $ (o 5 •71 POLICE $ t Zg i 29 FIRE/RESCUE $ 14.39 AERIAL FIRE TRUCK $ TOTAL CAPITAL EXPANSION IMPACT FEES $ S 3 • cif Calculation of Sewer Impact Fees (fund 401) (Prepared by the Building Department) SEWER IMPACT -RESIDENTIAL SEWER IMPACT -COMMERCIAL SEWER TAP FEE TOTAL SEWER IMPACT FEES $ 1,34g.$a $ 1,313.S0 1-0tkL '1 °) \ 3.11 Turnkey Construction 2640 Brookshire Circle Melbourne FL 32904 (321)403-3263 please email back to Brandytorres81 @yahoo.com Thank you! 3Jfl I15- u;\PC0 C�� DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 PENNELLA, JOHN M JR BEST ELECTRIC OF PALM BAY, INC. 1364 MIT COURT NW PALM BAY FL 32907 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE RICK SCOTT, GOVERNOR STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION EC13006170 ISSUED: 07/14/2014 CERTIFIED ELECTRICAL CONTRACTOR PENNELLA, JOHN M JR BEST ELECTRIC OF PALM BAY, !NC. IS CERTIFIED under the provisions of Ch.489 FS. Expiration date AUG 31, 2016 L1407140000209 KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD LICENSE NUMBER EC13006170 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 PENNELLA, JOHN M JR BEST ELECTRIC OF PALM BAY, INC. 1364 MIT COURT NW PALM BAY FL 32907 BREVARD COUNTY BUSINESS TAX RECEIPT 2014 - 201 5 SUBJECT TO COUNTY ZONING RESTRICTIONS TAX RECEIPT SHOULD BE DISPLAYED ON PREMISES THE PERSON(S), OR ENTITY BELOW: DOUG HAMBEL'S PLUMBING INC 4190 DOW RD MELBOURNE FL 32934 LOCATION: 4190 DOW RD UNINCORP DIST. 5, FL 32934 OWNED BY: BUSINESS PERIOD: ACCOUNT NO. 885001372 OCTOBER 1, 2014 - SEPTEMBER 30, 2015 EXPIRES: SEPTEMBER 30, 2015 ISSUED PURSUANT AND SUBJECT TO FLORIDA STATUTES AND BREVARD COUNTY CODE ISSUANCE DOES NOT CERTIFY COMPLIANCE WITH ZONNO OR OTHER LAWS. BUSINESS TAX RECEIPT IS SUBJECTTO REVOCATION FOR ZONING VIOLATIONS, AND / OR FAILURE TO MAINTAIN REGULATORY PRE•REQUSITES AS REQUIRED FOR BUSINESS CLASSIFICATION(S), OR SUBSEQUENT ACTIVITIES. NOTIFY TAX COLLECTOR UPON CLOSING OF BUSINESS. A PERMIT IS REQUIRED 10 ADVEFMSE (Inducting with slgnage)'GOING OUT OF BUSINESS'. LISA CULLEN, CFC, Brevard County Tax Collector P 0 Box 2500, Titusville, Florida 32781.2500 (321) 264.6910 UPON A CHANGE OF OWNERSHIP OR LOCATION, BUSINESS TAX RECEIPT SHOULD BE TRANSFERRED WITHIN 30 DAYS. PROF. LICENSE REQUIRED DOUG HAMBEL'S PLUMBING INC DOUG HAMBEL CFC057818 BUSINESS CLASSIFICATIONS, DISCLAIMERS, AND RELATED FEES: PENALTY: 300480 PLUMBING CONTRACTOR 820005 2014 - 2015 RECEIPT AMT BRANCH OFFICES: MAIN OFFICE: • EXEMPTIONS: NON EXEMPT $.00 n $37.00 PAID 0 Merritt island Office, 1450 N. Courtenay Pkvvy, Merritt Island, FL 32953 Melbourne Office, 1515 Samo Road, Melbourne, FL 32935 Palm Bay Office, 450 Cogan Dr. SE, Palm Bay, FL 32909 400 South St„ 6th Floor, Titusville, FL 32780 (321) 264-6910, (321) 633-2199, ext. 46910 BTR•TXIRCPT--04 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD • (850) 487-1395 1940 NORTH MONROE STREET.. TALLAHASSEE FL 32399-0783 HAM BEL, DOUGLAS WILLIAM DOUG HAMBEL'S PLUMBING INC 4190 DOW ROAD MELBOURNE FL 32934 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and _ Profeasional .RegOli?tion. Our professionals and businesses range . from architeotsxayychf.brokers fram. bows_ to barbLeque_restauranfs ... and they keep Florida's economy strong. Every day we work to Improve the way we do business in order to serve you better. For Information about our services, please log onto www.myfloridaiicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license) DETACH HERE RICK SCOTT, GOVERNOR rt'1 'Yit1 rElL: ILCEBROW'T$..'sA3', 57,+xai Y:Prus.•Wi°431CSBOU&Ti21, ' •STATE :OF .,FLORIDA:' - ---DEPART r _iF�e B.U.S.INE.S.S_AI4D:. PROF ';r.��jl, �+ ; ULATION . 150.81-9"s7/31/2014 ;. -• RT•IFIEIZP. - .un '4t:L-e. +n s Y (3 nisra r OOD196� • • KEN LAWSON, SECRETARY STATE OF FLORIDA •DEPARTMENT OF BUST SS,AND PROFESSIONAL REGULATION - •CONSTRUC'f•I ".,,:INDUSTRY UCEN81NG BOARD • • LICENSE NUMBER TFa0",PliJMBING102 CTQRc:..;; y:-�;.- ` r N dial d tielori'rS I FI ED- , r• ;'Gr z ; 1. •• - • �oqi f Fia ter -�;� .;,� �,•,• ,���; . _` -,�;1'ndr•fhe:'� .�'tan�� '4��.Sr- ..• e� . • '1 'ti, , fir` �• pO.klt;.HP,iN$RJ S.,P ,��, v Naar ,,::,s:.�, �• :�� ,� > ,,�:> u ,��� � �:, .,, �..'�ti. , I0M Icn. f17P4 P114A ra�,rry,i nicoi 4V 4C l (ll IIDCr1 RV I ANAI 11t L�• ■ • i \■3 \ CPA 1k 1 1A(17Z1tY1fl174A ACORb `� CERTIFICATE OF LIABILITY INSURANCE DATE (MM DD/YYYY) 4/9/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Brown & Brown of Brevard 7341 7341 Office Park Place Suite 202A Melbourne FL 32940 CONTACT Pam Watson NAME: A/C. N (321) 757-8686 FAX (321) 757-9687 (( i LAIC. N91: EMAIL INSURER(S) AFFORDING COVERAGE NAIC e INSURER A :Westfield Insurance Company INSURED Doug Hambel's Plumbing, Inc. 4190 Dow Road Melbourne FL 32934 INSURER El.PFVA Mutual Insurance Company 10385 INSURERC: INSURERD: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER:CL154914657 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADM ADM INSO SD MND POLICY NUMBER POLICY EFF IMM/DDIYYYY1 POLICY- EXP IMM!DD/YYYY) iiiidt COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS -MADE __J OCCUR DAMAGE TO RENTED PREMISES1Ee_ocanencel S MED EXP (Any one person) S PERSONAL & ADV INJURY S GERI AGGREGATE LIMIT APPLIES PER: POUCY JECT LOC OTHER: GENERAL AGGREGATE S PRODUCTS - COMP/OP AGG S $ A AUTOMOBILE X X LABILITY ANY AUTO AOWNED AUTOS HIRED AUTOS r SCHEDULED NON -OWNED AUTOS CW1312791 4/12/2015 4/12/2016 COMBINED SINGLE LIMIT (Ea occident) $ 1,000,000 BODILY INJURY (Per person) S BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per acrddeM) S Underinsuredmotonst $ 500,000 UMBRELLA UAB EXCESSLJAB HOCCUR CLAIMS -MACE EACH OCCURRENCE $ AGGREGATE S S OED RETENTIONS B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER In H) EXCLUDED? y (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA wC840-0030142-2015A 1/11/2015 1/11/2016 pT}�. STATUTE ER EL EACH ACCIDENT $ 1,000,000 S 1, 000 000 , EL DISEASE -EA EMPLOYEE E.L DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION City of Cape Canaveral Building Department 7510 N Atlantic Ave Cape Canaveral, FL 32920 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Mark Cobb/PAM ACORD 25 (2014/01) I NS025 rr1 en11 01988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DOUGHAM-02 MVANDERLEE ACORO' CERTIFICATE OF LIABILITY INSURANCE �� DATE(MMIDDIYYYY) 4I9/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # L087297 Hub International Southeast 3760 N. Wickham Road Suite 2 Melbourne, FL 32935 CONTACT PHONE 321 266-2220 --� F- UVCNo. Eatt:( (AK.No): AADOREss: INSURER(S) AFFORDING COVERAGE NAIC a INSURER A:Cincinnati Insurance Company 10677 INSURED Doug Hambels Plumbing Inc 4190 Dow Rd. Melbourne, FL 32934 INSURER B : INSURER C: INSURER D : INSURER E: INSURER F : ES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR TYPE OF INSURANCE ADOL INSO SUBR WVD POLICY NUMBER POLICY EFF IMMIDDIYYyV) POLICY EXP' WAITS (MWOONYYY1 A X COMtdERCIAL GENERAL UABIUTY CAP5239265 04/12/2015 04/12/2016 EACH OCCURRENCE S 1,000,000 A MISES EReEMo tfD9nC6) DPR $ 500,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 X Emp Ben. 1mmll mm PERSONAL&ADVINJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE OMIT APPLIES PER. POLICY ❑ JEC LOC OTHER PRODUCTS -COMPAP AGO S 2,000,000 S AUTOMOBILE _ — _ LIABILTTY ANY AUTO ALLOV`NED AUTOS HIRED AUTOS -_ _ SCHEDULED AUTOSNON-OWNED AUTOS COMBINED SINGLE UMIT (Ea accident) S BODILY INJURY (Per person) S BODILY INJURY (Per accident) S PROPERTY DAMAGE (Peraoddentl S S A X UMBRELLA LJAB EXCESS LIAR X (KY:UR CLAIMS -MADE CAP6239286 04/12/2015 0M1212018 EACH OCCURRENCE S 1,000,000 AGGREGATE S Aggregate S 1,000,000 DED RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Ya IM OFFICEREMBER EXCLUDED? (Mandatory In NH) If yea describe under DESCRIPTION OF OPERATIONS below N/A pQ��'' I ERH- STATUTEPE EL EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE S E.L DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS ( LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If mots space Is required) CERTIFICATE HOLDER CANCELLATION City of Cape Canaveral 7510 N Atlantic Ave Cape Canaveral, FL 32920 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 26 (2014/01) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD S. * Re✓ism Wi.Ja5 4z: /2 7—z3 —f5 City of Cape Canaveral Community & Economic Development PLAN REVIEW CORRECTION SHEET Date of Review: 9-16-2015 Applicant Name: Turnkey Construction Project Name: Single Family Residence Phone Number: (321)-288-6415 Project Address: 127 Oak Lane E-mail: Brandytorres81@yahoo.com The following items were noted on your submittal as areas requiring correction and/or clarification. Please address each comment by its corresponding number. You may fax replies to (321) 868-1247. If you have any questions about this plan review please call (321) 868-1222 and ask to speak with the Plans Examiner or Building Official. Please amend all copies of the previous submittal to reflect any necessary revisions and re -submit to the building department. This re -submittal will be reviewed by the Plans Examiner and will result in either a permit or an additional plan review comment sheet. Your application will remain on file for six months from the date of submittal. Please provide the following additional information: 1. Provide Engineer sealed clarification letter or revised sheet, that design meets current ✓ 2014 FBC 5'h Edition and 2011 NEC. One conflict in drawing data; Project Data Summary on drawing sheet 2 states older codes. 2. Design pressure for OH Doors on drawing sheet 2, minimum required pressure for / 150mph Exposure C is +24.6/ -27.3 psf. Drawing was marked to note this. �/ Submitted OH Door data of +30/-30psf is good and meets FBC. No action required on this item. 3. Engineer to clarify how many places this larger footing detail applies? "Typ Porch Block Column Pad" detail "ftg.8". 4. Engineer to clarify NEW FRONT PORCH DETAIL on drawing page 4. Note calls - / for triple 2 x 12 wd beam, contrary to note on drawing page 1. ✓ 5. Clarify ceiling insulation proposed, R-30 is called for in energy efficiency data. Drawing states R-19 minimum. 6. Provide approved and signed Concurrency documents. ?C1-)1") °l-25-15 Joe Maciejko, Building Plans Examiner Cc: Mike German, Building Official 110 Polk Avenue — P.O. Box 326 — Cape Canaveral, FL 32920-0326 Telephone (321) 868-1222 — Fax (321) 868-1247 www.cityofcapecanaveral.org e-mail: info@cityofcapecanaveral.org