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Home My WebLink AboutBLDG PERMIT #10338 (Water Heater) #109 10%31/2013 00:27 3217991714 PAGE 03 Date: [� / RECE V D CITY OF CAPE CANAVERAL OCT 3 0 2013 BUILDING PERMIT APPLICATION Permits 3 � (321)$6&1222 City of Cape Canaveral Building Depw nneat -7510 N.Atleade Ave.-Cape Canaveral,FL 32920 You may download this application �vw.�f�� ave ora. You may fax to: (321)86$.1247. All alaplicatlotis must include the backside of this farm. Impottattt; P she checklist. A lease complete the checklist on the back of this form and provide other dccr�m�rot$bm as.inriltti3 PA copy of contract may be Mquired. AppilaWort packages will not be accepted APPLICANT WILL BE CALLED WHEN PEPT IS READY ess complete. MI (Contractor/Owoer.Buiidef is required to sign for the building permit,unless indicated otherwise by affidavit. I.D. Address of Job Site: w MY be required) L%W deseri on of o '� 9 Zoning classKfi�tian:__Flood Zone:_ Property OwnerName: :T►aN: R{0: SF.tr: SUBA: 13LK: LOT: P13: PO: N Phone: Addrsss: �8G ,r. Fee Simple Titleholder's Name(Woo ar s,an o,w): Address: Bonding Company: Address: Mode Lendcr' Address: Type dPermit Briefiesoription of work. Building Electrical Plumbinge,,rMechanical Lj Other Type of $qd covet, ow mama *er for for Moi Not VptaptTon of work *050 � (m ch"Ift D Is � l sisrie rlreei>• bei- water teoyrorCoovacramubae> indicate as roof VB, Mian serve this this parift Ma etoseta appiiwbie) ede) 1,I3 es/NP�Y Spasat Y mmercial S a FR to, ownhouse >i partment S Is Archited%ngineer Nam, Name of Con"ay: Address: State License No.: Phone(office). Phone(cell/pager.): Primary Contractor Nance: Name of Company: Address: State License No. Phone(office): (cell/pager): Fax: Electrical Contractor Name: Name of Company. Address: ,,•„ State License No.: Phone(office): Phone(celypager.): Fax: Plumbing Co Name: �i N e of Company: * e r'/r Q' Address i4p AAMO +i? State License No.; ! 'Z46/k, Phone(office): 1"hone(cell/pager.): Mechanical Contractor Name: Name of Company: Address: State Lice=nse No.: Phone(office): Phone(celYMcr.): Fax: Specialty/Other Contractor Name: Name of Company: Address: State License No.: ... . ...._. Phone(office):,, Phone(cell/pager.).. _Fax: 10431/2013 00:27 3217991714 PAGE 02 , �( IEd4,I Perptft Ap licstioo ClE"klist Com leted Permit A lication Notes Currerrt surae Showln all Cwrepl code114 ithari! IF•Hidg Code 2010(as ) NoWrized A tore_ sed construction and Ian i ct k with Idg.DePL far setlrao)cs at'nw/$uilder Affidavit Sewer Impacst Fee rem contlaetor Count Int Feb r ' wqi C.O.Unlas•iob is iem*Mns itai E cion 1 t F ee recei t �brred umtl C.6, Sidewalk l Fee ' f p Ma deferred Recorded Warman Deed/ trsidewalk;Won to: Proofof Uwnershi Co of Recorded Notice of i.;oIIIII IfI !III!I If!I111,1111till 111,over 00 ova,87,500 for Mee Ical 8e our Current Cert.Of Liabil Ims./Worker's Co ,Poli /lrxem tion ward be kept on rile atter auNo1 Commi AXZMCe Board royal Ford work vistbla front public p�.�y�� Plana and Zonin Board Site Plan roval Foraq naw on offourunttsorew,e Conctu7crt PormS Far ail new 74 Pon of»pprordd 0-ft;as Primary Contractor's State License Record will be kept on file after in �rbmiast Subcontractor°s Authbri�tions: Record wig be kept a file after inWW subntitw State License Notify buiidins Depameent of comacwr ahmigas Plu3rttbiq Contractor Plumbing Contractor Electrical Contractor Electrical Corrtaactor Mechanical Contraotor Mechanical Contractor Roofing Contractor Roofing Corriractor Swtmmin Pool Contractor Swimming Pool Contractor Gass Contractor Gas Contractor Specialty/other Contractor j Speciahy/other Convactor Construction Drawings: Per F.B.C.104 Tkrce sets of sealed eoustruedon drawings —.1;V8 .104 Truss layout and reaction sununary Cut attests and shop drWRI will be Qar&Wof 6mp. Electrical Load Calculations pians must kndicsta person rapoosib for calcuiatiarrs lvlectrical Riser All new mI must be located u omtd 1.Plurnbing Miser Plans must;;;;a persat responsible for design A/C la out Plans must Whom parson responsible fm'design Two sets of Energy Calculations Plans Burst 'rate person ressponaible fo cal catations Lot Drain a fitrrve Four sets of Fire Su ression/S kler/Alarm s lflcatlons ltgWm Fin:Dept.approval prior to prance of Perna Pool Barrier Requirement Form(signed) Pool permlb will not be issued wrihout barrier Application is hereby made to obtain a permit to do the work and installations as indicated. t 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 Flori Building Code 2010 Edition. F 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 perni t. 'BALL OTHER APPLICABLE STATE OR FEDERAL PERMITS MUST BE OBTAINED PRIOR TO'CO/QjCEMEN7T* • ' A:��7q*�ntraaoessignatum: Contractor sName• /'f i rc' Date: AZ Site Address: /�e �a.'G ��. 1b9 For Notary use only: State of Florida,County of Brevard Sworn and subscribed before me this 3/qday of cat?f'�` ,20LL by M e PI n me of Appliaent 11Qwho produced identification: or is personally known to me. Seal: r � COMWS 1 L 0 00961 signature-Notary Put-lie At Large /O- i^ a! •� MY COMMiS9lf3N 0 D0961394 WIRES POWU y 14,2014 This t �OtiBa PkMktkNae .dant 10431/2013 00:27 3217991714 PAGE 01 CITY OF CAPE CANAVERAL, AUTHORIZA.TION FORA City'> C'"CaMvWW8WW'n8D6PMftW 7510 N.Atlantic Ave, Cape Caaverai,F1„32820 (321)US-1222 (You ty dawnb W da nguinfim YOU=y fax to:(321)865-1247. Date: /+ 3/ / Permit#: 10338 CONTRACTORS AND SUBCONTRACTORS-PLEASE HAVE YOUR SfGNATURE NOTARIZED AND SUBMIT THIS FORM WITH TIME PERMIT APPLICATION. Company Name: 'e' rjAC/� �;,` ag ,herebyaauthorize Ute/ ,e-4P N (State License Haider's Name—PI„$ASE PkM Autivitmi Pan_PIX Y. ( n to obtain a permit on my behalf under my state licenses}as issued by the Department of Business and Professional Regulation,Construction Industry Licensing Board {State License Numfier(s)) for the job site described below. An authorization will be required for each permit Type of Emit �xn U.)= 4ts;"" Builftg Name of Property Owner Plumbingp /�� Electrical Address of Job Site Mechanical Roofiig Swimming Pool pecialty Structure Sigma a of License Halder S Other—Specify: For Notary use only: State of Florida,CM*of8revjvd. Sworn and subscribed befbre me this' day of /� ,20�by Name of Applicant who produced identification: or Is personally known to me. MY C=M=*N 0 DONIN4P. ��"' Seat: EXPRES FeDmary 14,2014 Oat) Sigrtmure-Notiny Public At large G*%1d&DeptF9rmslAuttgrimtw Fmm This form may be duplicated.