HomeMy WebLinkAboutBLDG PERMIT #6451City of Cape Canaveral, Florida
MECHANICAL PERMIT
PHONE: 321-868-1222
Permit #:6451 Issued: 5/15/2005
Permit Type: MECHANICAL
Class of Work: 434- Add./Alt. & Reroofs Res.
Proposed Use: Condominiums (R-2) (3 or More)
Sq. Feet: Est. Value:
Cost: 3,500.00 Total Fees: 70.0
Amount Paid: Date Paid:
Name: A THERMAL MANAGEMENT CORP
Addr: 357 MILFORD POINT RD
MERRITT ISLAND, FL 32952
Phone: (321)458-0642 Lic: CAC057107
Work Desc: A/C CHANGE -OUT (UNIT #311
nal Mechanical
(CATION ACCEPTED BY: P
INSPECTIONS & FAX: 868-1247
6451
Address: 230 COLUMBIA DR #311
CAPE CANAVERAL, FL
Township: 24 Range: 37
Lot(s): Block: Section: 22
Book: 18 Page: 9
Subdivision: COLONIAL HOUSE CONDO
Parcel Number: 24 372202 446
Name: MAZAUDON, ALAIN
Address: 7201 RIDGEWOOD AVE #21
CAPE CANAVERAL, FL 32920
Phone:
BY:/<1 - % APPROVED
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 _'TARTFD_
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
I HIS 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
PROVJSIONS OF ANY OTHER STATE ORLCLCAI LAW R GL LAI%r CONSTRI ICTIr1N GR THF PFRFO ANCF CIF 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
IS/SUED BY/DATE `
Date: PE CANAVERAL Tracking # - 06 RECEIVED -7
CITY OF CA -7
MAY 14 2009 BUILDING PERMIT APPLICATION Permit #
(321) 868-1222
City of Cape Canaveral Building Department 7510 N. Atlantic Ave. Cape Canaveral, FL 32920
You may download this application: www•.inyflorida.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:: '(„ %,° \ Zoning classification: Flood Zone: --4 —
Legal description of property: TWN:_11RNC;: SEC: 7 SU Cuoa�, �;BLK: — LOT: — PB:IT PG:
Property Owner Name:; t ,, Phre ? fe
Address: 1` ® 2>c,,y1 A of � V-� � �
Fee Simple Titleholder's Name (if other than owner;: ;, ;ate Address
Bonding Company: ['41 Address:
Mortgage Lender: 112 Address:
s:
Type of Permit Brief description of work: a
Building + -
Electrical
Plumbing
Mechanical c°
Other
Architect/Engineer Name:
Type of
Name of Company:
Const.
Occ-
FPL lines
City Sewer
Will this
State License No.:
Phone (office):
Phone (cell/pager.):
Fax:
Primary Contractor Name:
Building
g
Square
Feet
Type
upancy
currently
available
structure
# of
# of
# of
# of
Valuation of work
Name of Company:
Address:
(IA,
Group
available to
to serve
have built-in
stories
dwel-
bed-
water
Name of Company:
(please
under
VB,
(B,R1,
serve this
this
gas
Fax:
line
rooms
closets
NViv" A "'-i
Address: S—) j rim ' c,
indicate as
roof
etc)
etc.)
property?
property?
appliances?
units
Address:
applicable)
State License No.:
Phone (office):
Phone (celUpager.): _
Yes/No
Yes/No
Yes No
l
$
$
VSFR
u
$
$
Architect/Engineer Name:
Name of Company:
Address:
State License No.:
Phone (office):
Phone (cell/pager.):
Fax:
Primary Contractor Name:
Name of Company:
Address:
State License No.:
Phone (office):
Phone (cell/pager.):
Fax:
Electrical Contractor Name:
Name of Company:
Address:
State License No.:
Phone (office):
Phone (celL'pager.):
Fax:
Plumbing Contractor Name:
Name of Company:
Address:
State License No.:
Phone (office):
Phone (cell/pager.):
Fax:
Mechanical Contractor Name:Ao,
d rs _
Name of Company: j " V"�j
NViv" A "'-i
Address: S—) j rim ' c,
-` ;1&
-
State License No.::. A (�,- 1 t)'r Phone (office): 3 1
K Phone (cell/pager.):
Fax: i d Stj 1 $
Specialty; Other Conuactor NWILU.
Name of C ompany:
Address:
State License No.:
Phone (office):
Phone (celUpager.): _
Fax: _
G:\BIdg.Dept.Forms\BP APPLICATION Rev. August 20, 2(_08
Building Permit Application Checklist
Notes
Completed Permit Application
Current code edition: FL Bldg. Code 2004 (as revised)
Current survey showing all proposed construction and landscaping
Check with Bldg. Dept. for setbacks
Notarized 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 $5,000 for Mechanical change out
Current Cert. Of Liability Ins./Worker's Comp. Policy / Exemption
Record will be kept on file ager 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
Pr iiiiaiy ContraCtor'S State License
Record will be kept on file after initial submittal
Subcontractor's Authorizations:
State License
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
Roofing Contractor ofin Contractor
Swimming Pool Contractor Swimming Pool Contractor
Gas Contractor as 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
Trus 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 ,rust indicate person responsible for calculations
Lot Drainage Survey
Four sets of Fire Suppression/Sprinkler/Alarm secifications
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 2004 Edition. I understand that all permits require inspections as indicated. This permit
application is valid for six months from date of submission. By signing, applicant affirms that all above is true and
correct —I that he/she is an authorized agent of the Contractor/Owner and has the authority to apply for this permit.
Applicant's Name: ,'-1 t tA�l? Applicant's Signature:
Date: / Site Address: � 30
a
For Notary use only: State of Florida, County of Brevard
Sworn and subscribed before me this 14 day of > 4�4 20 / , by , r -c" --\
Printed name of Applicant
nwho produced identification: or
L I iJ perSGnaiiy nri�wn tv nie.
�� V �u4erotary Public State of Florida
Seal: Joy Lombardi
Z.10 lAY Commission DD688496
rof ,O Expires 08103/2011
c;:\B1dg.Dept.FonnslBP APPLICATION Rev. August 20, 2'0U8
15�' Signature - Notary Public At Large
This form may be duplicated.
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321458-1642 COCOA, FL32926
# CAC OSILI0I
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PERMIT AUTHORIZATION
(PLEASE PRINT ALL INFORMA TION LEGIBLY)
NAME OF FIRM:
QUALIFIER/ LICENSE HOLDER:
LICENSE NO.: (L C) c~ > J/) --7
do hereby authorize
to obtain a permit on my behalf under my license for the job at the following
address: 2x e--' C'
4o L'gense HoRi—er
- s14/
Date '
This foregoing instrument was acknowledged before me this J(il' day of1211111 1
IL7
who is personally known to me or who has
,ntification) as identification.
(STAMP)
SANDRA S RODRIGUEZ
pied !S-STON # DD472247
AOS
'4117,311 015,*,
ncAaa Notary SeMee.com
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05/1 13/2008 13:47 FAX
L-FRE—DO ARTFAGA JR- & ASSOCJAM INC.
NCEhozEERING CONSULTANT
50 WJEST 68TH ST.
IM,F—AH, FLORIDA 33014-5235
EL -FAX, -305-828-7876 CA3885
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PERMITTED FOR CO)NS7-, U�0-7
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REVIEW
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05/18j2nO8 13:48 FAX
p � o ARTFAGA jR. &.ASSOCIATES INC.
ENGEqEERING CONSULTANT
850 NyEST 68TH ST.
HIALFAH, FLORIDA 33014-5235 CA_3885
TELFAX: 305-828-787G
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