HomeMy WebLinkAboutBLDG PERMIT #16-0267 (A/C) Unit #208Date: 6'11C CITY OF CAPE CANAVERAL Tracking #1_ql
RECEIVED BUILDING PERMIT APPLICATION Permit # — T
APR U 2016 (321)868-1222
City of Cape Canaveral Building Department - 7510 N. Atlantic Ave. - Cape Canaveral, FL 32920
You may download this application: www.citvofcapecaeaveral.or¢. 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
(Contracior/Owner-Builder is rcquircd to sign for the building permit, unless indicated vtherwisc by affidavit. I.D. may be required)
Address of Job Site: —, s, 3 0 eC &"kIf a I( A d? Zoning classification: Flood Zone:
Legal description of property: Twf1: RNQ SEC; SUBD; BLK LOT: PB; Po:
Property Owner Name: [C Phone:
Address: V30 p
Fee Simple Titleholder's Name (irother than owner); Address:
Bonding Company: Address;
Mortgage Lender, _ Address:
Type of Permit Brief description of work:rfarA Q.
Building -
Electrical
Plumbing
Mechanical
Other
Type Of
Square
Const. occu- FPL lines
City Sewer pof
#of
#ot
qof Mof
Fax:
Building
Feet
Type panty currently
avanahle Concrete/
stories
dwel-
bed- water
Valuation of work
(please
under
(lA, Classlllca available to
to serve Asphalt
State License No.:
ling
rooms closets
(Copy o(f:on[race Rtquptd)
indicate as
roof
VB, -tion serve this
the/ Parma
State License No.:
unite
Phone (cell/pager.):
do
applicable)
a0) R3 property?
property? Spaces
State License No.: CA C o y/2
Phone (office):
_Phone (cell/pager.):
�
i/ ��/��
Specialty/Other Contractor Name:
Address:
State License No.: _.... _
_ Phone (office): ,
ere. Yes/No
cte.)
_
Fax:
Commercial
$
FR
s
Townhouse
$
Apartment
g
ondominiu
5
ther
s
Architcct/Engineer Name:
Address:
_
Name of Company:
State License No.:
Phone (office):
Phone (cell/pager.):
Fax:
Primary Contractor Name:
Address: _
Name of Company:
State License No.:
Phone (office):
Phone (cell/pager.):
Fax:
Electrical Contractor Name:
Address:
Name of Company:
State License No.:
Phone (office):
Phone (cell/pager.):
Fax:
Plumbing Contractor Name:
Address:
Name of Company:
State License No.:
Phone (office):
Phone (cell/pager.):
Fax:
Mechanical Co tractor Name:
Address: , o
Name of Company:
r
.
State License No.: CA C o y/2
Phone (office):
_Phone (cell/pager.):
Fax:
Specialty/Other Contractor Name:
Address:
State License No.: _.... _
_ Phone (office): ,
_ Name of Company:
Phone (cell/pager.):
_
Fax:
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04/26/2016 11:55 FAX
10001
,J Building Permit Application Checklist
Notes
Completed Permit Application
Curmt code edition: FL Bldg. Code 2010 (as roviwd)
Current survey showing all proposed construction and landscaping
Check with Bldg. Dept. for setbacks
Notarized signature -- Owner/Builder Affidavit
If owner is acting as contmotor
Sewer Impact Fee receipt
May be defend until C.O. Unless job is remodeling
County Impact Fee receipt
May be deferred mail 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 ehai,ac teat
Current Cert. Of Liability insJWorker's Comg. Policy / Exemption
Record will be kept an file after initial submittal
Community Appearance Board Approval
For all work visible &ottt Public Right -Of -Way
Planning and Zonihg Board Site Plan Approval
Por 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 he kept on file after initial submittal
Subcontractor's Authorizations:
State License
Reemd 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
Roofinp Contractor Rdofing Contractor
Swimming Pool Contractor Swimmin Pool Contractor
Gas Contractor Gas Contractor
Specialty/Other Contractor Specialty/Other Contractor
Construction Drawings:
Per F.B.C. los
Three sets of sealed construction drawings
Per F.R.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 prnmun responsible for calculations
Electrical Riser
All new service must be located wrdaground
Plumbing Riser
Plans must indicate person responsible for design
A/C layout
Plans midst inditmte person responsible for design
Two sets of Energy Calculations
Plans must indicate person responsible for calculations
Lot Drains c Survey
Four sets of fire Su ression/S rinkler/A)arm specifications
Requires Fire Dept. approval prior to issuance of permit
Pool Barrier Requirement Form (signed)
Pool permits will net be issued without battlior
Application is hereby made to obtain a permit. to do the work and installations as indicated. 1 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: 4l Contractor's Signature!��,„
Date: C Site Address: A?30 Cb r% P"111 f
For Notary use only: State of Florida County of B yard ^C S
Sworn and subscribed before me this_�tTay of Yl L , 20, by S W IV t
Printed trema of Applicant
who produced identification: or
is personally known to me.
Seal: ,o: ,,
KAREN HUTCHINSON _Y � '( � �—
=� F = MY COMMISSION 9 FF 951009
EXPIRES: January 18, 2020 Signature - Notary Public At 1 urge
y'. •O:
6. 10111- 1,111!iuvBG t�Ii:�B,ded4ThiuNptary blitUOd� d(grs Ibis form may be duplicated,