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Home My WebLink AboutBLDG PERMIT #11986 04/08/2015 12:06 FAX @001 Date: ?� < CITY OF CAPE CANAVERAL Traeldng# RECEIVED BUILDING PERMIT APPLICATION Permit# APES 0 0 2015 (321)868-1222 City of Cape Canaveral Building Department -75 to N.Atlantic Ave.-Cape Canaveral,FL 32920 You may download this application: WMX.ci feral.oI You may fax to: (321)858-1247. 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 bu din rink unless indicated otherwise by a0ldevit. I.D.may be required) Address of Job Site: 2.30 OMM— & UV_ Zoning el"fiedion: Flood Zone: RiK ' LOT: S:, PG:-- Leo C:✓—Legdescription of.3paro TWNr: SC% 5U�' : 7/70 PropertyOwnrNme: z Phone; 41 Address: Epee Simple Titleholder's Name(irafte"Mawter): Address: Bonding Company: Address: Mortgage Lender: Address: Type of Permit Brief description of work: Building Electrical Plumbing MechanicalI litP ()tltcr TyPe Of Square Cones. Oeeu- FPL lines City Sewer #of #of #of #of Not vatnatioo of work Feet Type paocurrently evefthle Coneretel storks dwel- bed- water (Con orcoouadbeflKe) .Building Claeytymes available to to serve Asphalt Ifog rooms closets Hader (IA, (Please roof Via -tins senna tbls this Porweis units Mesta as ate) (S�RrAS Property? property? Spaces applicable) Yeo ommercial S FR a ownhouse s parttnent ndomtini O � S .`� $ Lother Architect/Engineer Name: Name of Company: Address: State License No.; Phone(office): Pax:Phone(eell/pager.): - Primary Contractor Name: Name of Company: Address: State License No.: Phone(office): Phone(cell/pager.): Fac: Electrical Contractor Name: Namo of COMM: Address: State Lictmsc No.: Phone(office)' Phone(cell/pager.); Fax: Plumbing Contractor Name: Name of Company; Address: S�License No.: Phone(office): Phone(cell/pager.); Fac Mechanical Contrnotor Name: Name of Com Address: 1 D { State License No.: phone(office);Y-61- Phone(calitpag IS&YCIJ j Far, bY Specialty/Other Contractor Name: Name of Company: - Address: State License No.; Phone(office): Phone(Cell/pager.): lax: 04/08/;015 12:06 FAX IM002 Building Permit Application Cbecklist Notes Com (ctrl Permit A lieation Cucrcut coon edrdon:&Bldg.Cole 2010(as revisal) Cturent s shawl all sed construction and lChack with ells.Dept.fos'se� Notarized si a Owner/Btrilder Affidavit MIf owner is canna as contracmr Sewer Im t Fee receipt ay ba dat�rod until C.O.Urilmlob is remodeling County Impact Fce rete' t May ba dedkrred C.o. Capital Expansion Impact Fee receipt Maybe dbrred ta b C.O. Sidewalk Impact Fee receiPt IfsMewalk dx9i on lot RecordedWarren Deed/Proof of Ownershipp-F�00 fMo Mcobmd=1 change out Co of Recorded Notice of Commencement ovcr$2,500 Record vAU be k-P an file W whial subntitt� Current Cert.Of Liability Ins./Workcr's Comp.Policy/Exem tion For all workvisibie ftom Pub( Risatt Of-Way Community A earance Board Approwel For as new cmatruction of four units or more Planning and Zoning Board Site Plan A roust For all new consc=6W not tort of approved site plan Concurrent Forms _ RcwW will be kept on Do after fiRR submittal Primary Contractor's State License Subcontractor's Autborizations: Record be kept an filo este initial submittal Notify Buffufiding OR-Krtsram'of eongaotor ahengas State License Plumbing Contractor Plumbing Contractor Electrical Contractor Electrical Contractor Mechanical Contractor I Mechanical Contractor ItoofinContractor Roo Contractor swimming Pool Contractor Swimming Pool Contractor Gas Contractor Gas Contractor Specialty/other Contractor I Spccialty/0ther Contractor Construction Drawings: P�F B.C.104 Three sets of sealed construction drawings Per F.B.C.104 a Cut sh Truss layout and reaction sum sheets No shop drawings thio be utmded at time of insp. Electrical Load CalculationsPlops must indicate Parson responsible fur Wculadotts Electrical Riser All naw service mast be located rmdeWouad lr El�bin Riser Plan nu64t judicata Person rasponsibte far design A/C la outPlans mmi indicate Parson responsible for design Two sets of EntAry Calculations —PI=—Mud Indicate PMW r ewonsible for csyle"oW - Lot bran SurveyItequiras Fire Dept approval Prior touance issof 1n Four sets of Fire S ression/S rinklcr/Alarm c ifications �lpenni�will �ia�rel without barrier Pool Barrier Requirement Form si ? 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 20 10 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 aff= 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 pYFMRI *ALL OTHER APPLICABLE STATE OR FEDERAL PERMITS MUST BE OBTAT MMEN Contractor's Name: ut%° Contractor's Signature: Date- L�'g-�G/ Site Address: For Notary use only, State of Florida aunty of Brev' rd , Sworn and subscribed before me this day of 20-->�by W1 name of PPlicsnt who produced identification: or is personally known to me. "N"E UNKEY Seat; r g t�' •. MY COt�gyitB8lbN N FF2Q46w5 ��o-Notary Public At �' i:xt�tes Fetuuary a^8..Z019 This form may be duplicated. •' ....7.yiq.Ni d lrlo*d�WOq C9N