HomeMy WebLinkAboutBLDG PERMIT #18-0349 (AC HANDLER) #103City of Cape Canaveral, Florida
Building Permit
PHONE: 321-868-1222 INSPECTIONS & FAX: 868-1247
PERMIT #18-0349
CUSTOMER #001605
J PERMIT INFO:RMATIONtd
LOCATION INFOR¢MATION00
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Permit #:18-0349 Issued:12/29/2017
Address:230 Columbia Dr Unit #103
Permit Type: MER
Cape Canaveral FL, 32920
Cost: 1500.00 Total Fees: 109.00
PERMIT EXPIRATION DATE: 6/27/2018
Amount Paid: 109.00 Date Paid: 12/29/2017
r CONRA�CTORINf- ATION '`�,OWIVERsINFORMTION;
Name: Tom Hoskins Air Conditioning Inc
Name: Scott Adams
Addr: PO Box 320446
Address: 230 columbia Dr Unit #103
Cocoa Bch, FL 32931-
Cape Canaveral FL, 32920
Phone: (321)799-1073
Phone: (321) 799-1000
State Lic#: CAC050412
Local Lic#:
BP -Main: 75.00
BP -Plan: 0.00
BP -Surcharge: 4.00
Fire Plan Review: 0.00
Plan Revision Fee: 30.00
Plumbing:
Date Plan Revision Fee Paid:
Electrical:
Temp CO:
Capital Expansion:
After the Fact: 0.00
Re Inspection Fee Paid: 0.00
Mechanical:
Sewer Imapct:
Sewer Tap:
INSPECTIONS (for complete:list ,of.rdtlLdrej4 inspections. refe'r;.to.Hard'Card) {?.
NOTE: Once an inspection is approved by an authorized inspector the permit expiration date is extended six (6) months
from date of inspection.
Permit Desc: A/C CHANGE OUT (2
AIR HANDLER ONLY
I INSPECTION APPROVED BY: DATE:
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.
Sign & Date—► ! "(z •'/ x 1 Z./_ �/
Print
AUTHORIZED SIGNATURE / DATE
PRINT NAME
ISSUED / DATE
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Date: CITY OF CAPE CAN- AW' IRAL Treekingo
RECEIVED BUILDING PERMIT APPLICATION Permits
DEC 2 8 28.17 (320868-1222
City of Cape Canaveral Building Department - P.0 Box 326. 110 Polk Avenue - Cape Canaveral, PL 32920
You may dowtiload this application: wwvti� cit ty �fcau �cun ver LOU, You may fax to: (321)868-1247. All applications must include the
backside of this form and 2 sets of Supporting documents. 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�-aullder is required to sign for the building permit. unless indicated otherwise by affidavit. I.D. may be required)
Address of Job Site: eC 3 a , ed `o"' A 4. .0 /,0,7 _ Zoning classification: Flood Zone:
Legal description of property: TwN: RNO; SEC, SUBD; ai,K: t.o� PB: Po:
Property Ow ty- 7 otn C� e �—, �^���
Address: 4� Phone:
• ,�
Fee Simple Titleholder's Name (irotherUuu owner): Address:
Bonding Company: Address:
Mortgage Lender: _ Address:
T00 121 %V,d 09:V0 LT09/9Z/ZT
12/28/2017 04:20 FAX
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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 cotlstiuction in this jurisdiction, The Building Code in effect at the time of this application is the 112db
Building Code Sth 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 180
days from date of submission. By signing, applicant affirms that ail 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 OBTAINJFD PRIOR TO COMMENCEMENT*
Applicant's Name: oS1ej vL Applicant's Signature:
� Site Address:
Date: -
For Notary use only; State of Florida, County of Brevard
Sworn and subscribed before me this day of , 20 , by
Printed name of Applicant
Seal;
who produced identification: or
is personally known to me.
This fonn mmy be duplicated.
Signature - Notaiy Public At Large