HomeMy WebLinkAboutBLDG PERMIT #5596City of Cape Canaveral, Florida
BUILDING PERMIT 5596
PHONE: 321-868-1222 INSPECTIONS & FAX: 868-1247
PERMIT INFORMATION
LOCATION INFORMATION
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Permit #:5596 Issued: 2/28/2008
_
! Address: 230 COLUMBIA DR
Permit Type: WINDOWS & DOORS
1 CAPE CANAVERAL, FL
Class of Work: 434- Add./Alt. & Reroofs Res.
j Township: 24 Range: 37
Proposed Use: See specific use -residential
Lot(s): Block: Section: 22
Sq. Feet: Est. Value:Book:
18 Page: 9
Cost: 6,951.00 Total Fees: 152.50
Subdivision: COLONIAL HOUSE CONDO
! Amount Paid: Date Paid:
Parcel Number: 24 372202 416
CONTRACTOR INFORMATION
OWNER INFORMATION
Name: SUPERIOR DOORS & WINDOWS INC
Name: COLONIAL HOUSE AS INC
Addr: 3800 N. COCOA BLVD
Address: 230 COLUMBIA DR
COCOA, FL 32926
CAPE CANAVERAL FL 32920
Phone: (321)631-1340 Lic: WD 249 !
Phone: 321-784-9469
Work Desc: DOOR REPLACEMENT PER SUBMITTED SPECIFICATIONS
APPLICATION FEES
__ _ _
BUILDING OVER 2K 66.00-1P NREVIEW OVER 2K 42 50 FIRE PLAN REVIEW 25.00
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Inspe_ctiuns Required
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APPLICATION
ACCEPTED BY PLANS CHECKED BY APPROVED BY:
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 6 MONTHS, OR
IF CONSTRUCTION OR WORK IS SUSPENDED, OR ABANDONED FOR A PERIOD OF 6 MONTHS AT ANY TIME AFTER WORK IS STARTED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS DOCUMENT AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL
PROVISIONS OF LAWS AND 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 PERFORMANCE OF CONSTRUCTION.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR ANY ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
Totui s
Cash :amount
L�har!�e _
aw �.
vISSUED
BY/DATE AUTHORIZ D SIGNATURE/DATE
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Dat4: VCITY OF CAPE CANAVERAL
BUILDING PERMIT APPLICATION
Tracking # 02'-661K7
Permit # 5596
(321) 868-1222
City of Cape Canaveral Building Department 105 Polk Ave. Cape Canaveral, FL 32920
You may download this application: www.myflorida.com/cap . 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.
(Contractor/Owner-Builder is required to sign for the building pennit, unless indicated otherwise by affidavit. I.D. may be required)
Address of Job Site: 230 WLLM' _° Zoning classification: Flood Zone:
Legal description of property: TWN: -_
Property Owner Name: R SH ►p CrA,.)`
Address: 109 COLUU €(",, .
Fee Simple Titleholder's Name (if other than owner)
Bonding Company:
Mortgage Lender:
RNG: 37 SEC: 2 2- SUBD:
Mtn Rssccc .
Address:
LOT: PB: (''s PG=``
PhoneS-7-7-7
Address:
Address:
Type of Perrnit Brief description of work:
Building '
Electrical
Plumbing
Mechanical
Other I
Architect/Engineer Name:
Address:
Type of
Name of Company:
Const.
Occ-
FPL lines
City Sewer Will this
Fax:
Primary Contractor Name:
Address:
Name of Company:
{
State License No.:
Phone (office):
Square
Type
upancy
currently
available structure
# of
# of
# of
# of
Valuation of work
1i
Building
Feet
(IA,
Group
available to
to serve have built-in
stories
dwel-
bed-
water
!
State License No.:
(please
under
VB,
(B,Rl,
serve this
this gas
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ling
rooms
closets
indicate as
roof
etc)
etc.)
property?
property? appliances?
unit'
applicable)
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Yes/?V V
Yes/n`.o L CJ/ 1 V V
CQTYitYI P_.rctal
SFR
$
Townhouse
$
Apartment
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Other
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Architect/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.-
ddress:State
Name of Company:
StateLicense No.:
Phone (office):
Phone (cell/pager.):
Fax:
Plumbing Contractor Name:
Address:
Name of Company:
State License No.:
Phone (office):
Phone (cell/pager.):
Fax:
Mechanical Contractor Name:
Address:
Name of Company:
!
State License No.:
Phone (office):
Phone (cell/pager.):
Fax: i
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3pecia)iy,vncz Coutiac.wi Nz uc
Address: : SSCC t s C� -
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State License No.: 1
Phone (office) 'hone (cell/pager. k C8 a 7:a),_7
Fax(D. D L„33,11
G:\BIdg.Dept.Fonns\BP APPLICATION Rev_ July 20, 2006
V! Building Permit application Checklist Notes
j Completed Permit Application Current code edition: FL Bldg_ Code 2004 (as revised)
Current survey showing all proposed construction and landscaping*Ch-k with Bldg. Dept. for setbacks
Notarized signature - Gwner/Builder Affidavit owtedeferred
r is acting as contractor
Sewer Impact Fee receipt y until C -O. Unless job is remodeling
I G-VLLItt.Y kktkllaUL FCC keC;ekpl
may oe aererrea until L".(J.
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 $5,000 for Mechanical change out
Current Worker's Comp. Policy / Exemption
Record will be kept on file alter initial submittal
j Community Appearance Board Approval
For ail work visible from Public Right -Of -Way
t 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
j Subcontractor's Autliorkzatlons:
State License
Record wiIl be kept on file after initial submittal
Notify Building Department of contractor changes
1 Plumbing Contractor Plumbing Contractor
Electrical Contractor Electrical Contractor
( Mechanical Contractor Mechanical Contractor
f Roofing Contractor Roofing Contractor
i SuiiiMing Pool Contractor SwimmingPool f ntra
v _nr_fnr
Gas Contractor Gas Contractor
Specialty/Other Contractor Specialty/Other Contractor
Construction drawings:
Per F.B.C_ 104
I Two sets of sealed construction drawings (three sets if commercial)
Per F_B.C_ 104
i
j 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 f-- design i
Two sets of Energy Calculations
PIans must indicate person responsible for calculations i
Lot drainage Survey
Four Sets of Fire SuppreSSYOII/Spiillkier/AlatYil specifications
Requires Fire Dept approval prior to issuance of permit
Pool Barrier R uirement Form (signed)
, Pool permits will not be issued without barrier i
.t'a'aphvcAi,ctc,ivik is thereby itiQiSti', to obtain a pi%k itiit to do triG wC)riG dkiik 1rkJ Laliall(Ifks as rrA(dI(:atecl. I Ce'ruty thaT no Z'varK 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 tl'te
Florida Building Code 2004 Edition. I understand that all permits require inspections as indicated. This permit
application is valid for six rr�onths from date of subiriission. By sigziing, 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_
Applicant's Name:
Date: i -Z3 - i�.�``
A
Applicant's Signature: 'A K I "Ll
Site Address: 3 nOr
For Notary use onlay: State of Florida, County of Brevard
Sworn and subscribed before me this day of f ; 20 C , by IXi
dentification: or Printed name of Applicant
who produced i
is personally known to me.
i
Seal:
Sat' a et✓-lvotary Phi c At Large
G:`.Bldg_Dept.Forms\BP APPLICATION Rev_ July 20, 2006 f T-nis form, may be ol.cz.ed.
NOTICE of COMMENCEMENT
STATE OF k dLl
COUNTY OF 'i�;/l`-Lf
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 fproper yr: ((eaal descrit�tior� of
Z. General description of improvement:
and street address if available)
ea/9 d G'e_v-d 1, 1�/ -3_-? q y- tom'
3. Owner information:
a. Name and address: A 331 Gj ( �-i61
b_ Interest in property_
c_ Name, and address of fee simple titleholder (if other than owner):
4_ Contractor: (name and address) ( L - 6L Q or 5 �o - "V . S ��c40 q
a_ Phone number:
5. Surety: a. Name and address:
b. Phone number:
F t.e,nde-r' (n amenndRij�t'€Sfi�'
a. Phone number:
c_ Amount of bond S
7. Parsons with the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.130)(W, FIgrlda Statutes � _ � 4 f
_ , ,_ i ri A F., - i t L(1..� • A re �..� s sa sw
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(11'Ame aria CGQ_/��Pss , Gi4 sG.1 f'e-f...>a t 1 iid"vY,.v iG�l 3..}:...i ll i_..t ii.� iE:O 6 ILEh.F v . ✓'L;' -
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( ' l it i ,�; 1t ` r '( j .. �`u t F �i t"� i ( I b 2-
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8. In adon to himscif, Owner designates the follo-Ang p�on(s) to receive a c8py of the Lionor's Notice as provided in Section
713.13(l)(b), Florida Statutes: (name and address)
9. Expiration date of notice of commencement (the expiration date is one (1) year from the date of recording unless a different
date is specified)
This Space for Clerk's Use Only
CFN 2008013542, OR BK 5839 Page 7434,
Recorded 0112412008 at 11:39 AM, Scott Ellis, Clerk of
Courts, Brevard County
# Pgs:1
(signature of owner) Y!/ > �
NOTARY PUBLIC -STATE OF I±LORID7 a�dZ-d
Sworn to arsa'cxlBIFdrrr►'grinkley
this a"ommission # DD581725 -
S' .`:J"t:J 1Hitu AZ 1\Ti $0\D[4G CO., i G.
V r
TTO-r A Dy 'lir TRT 'f r
EWTO 39tid SdOOG SMOGNIM i3oGns 8608989ZZ8 96:T8 900E/T0/T0
Address: -
BUILDING PERMIT FEES:
Building Permit per squarefootage: ........................... .................................
Total Sq. Ft. (Living Area):
Total Sq. Ft. (Enclosed Area):
Q _..7 ,.7 n ------St 7-- --- --- - --
U U11ding 1 erynAL Uased ort valuatlon:......................................
Total Sq. Ft. (Living Area):
Total Sq. Ft. (Enclosed Area):.
3uilding Permit miscellaneous: .....................................................................
Total Sq. Ft. (Living Area):
Cotal Sq. Ft. (Enclosed Area):
?Iectrical..............................................................................................................
1.umbing...........................................
Jechanacal...........................................
;uilding Permit Plan Check Fee ...... ��5�,.-...., ............................2, Sy
'ire Dept. Plan Check Fee...............................................................I...............
radon Trust Fund: sq. footage ...........
-oncurrency Management Fee.........................................................................
-apital Expansion Fee........................................................................................
EWER PERMIT FEES:
:,.
Total Building Permit Fees:...... 512
SewerImpact Fee.....................................................................................
SewerTap .Fee ............ - . . ......................................................
Total Sewer Permit Fees .............
By: Date: / o
(You may download this authorization: www.myflorrida.com/cape. You may fax to: (321) 868-1247.
Fate: 6 - � � 'C5
Permit #- 5 5 9 l
CONTRACTORS AND SUBCONTRACTORS - PLEASE HAVE YOUR SIGNATURE
NOTARIZED AND SUBMIT THIS FORM WITH THE PERMIT APPLICATION.
Company Name:W i fqC
1, . Fh-akc—E&,� , hereby authorize I i )&-V1 cL (-� '
(State License Holder's Name - PLEASE PRINT)
(Authorized Person - PLEASE PRINT)
to obtain a permit on my behalf under my state license as issued by the Department of
Business and Professional Regulation, Construction Industry Licensing Board Wo p
49
(State License 'Number)
for the job site described below.
For blanket authorization, do not complete
&10-f 1—,Lu ' ;' 1
Name of Property Owner
Address of Job Site
I
Sigrture of License Holder
For Notary use only: State of Florida, County of Brevard
Sworn and subscribed 'before me this ZED day of r�-�_ 20 O , by
who produced identification:
LZ is personally known to me.
Seal:
W,
Name of Applicant
G:\BIdg.Eept.Fomis\Authorization Forn This form may be duplicated.
Type of Permit
Building
Plumbing
n4 B 1
i.i,_Cricaf
Mechanical
Roofing
Swimming Pool
Specialty Structure
Other — Specify: i
&10-f 1—,Lu ' ;' 1
Name of Property Owner
Address of Job Site
I
Sigrture of License Holder
For Notary use only: State of Florida, County of Brevard
Sworn and subscribed 'before me this ZED day of r�-�_ 20 O , by
who produced identification:
LZ is personally known to me.
Seal:
W,
Name of Applicant
G:\BIdg.Eept.Fomis\Authorization Forn This form may be duplicated.