HomeMy WebLinkAboutBLDG PERMIT #19-0892 (Replace cabinets)CITY OP
CAPE CANAVERAL
City of Cape Canaveral, Florida
Building Permit
PERMIT #19-0892
CUSTOMER #003418
PHONE: 321-868-1220 INSPECTIONS: 321-868-1204 FAX: 321-868-1247
PERMIT INFORMATION
=- :. LOCATION
Permit #: 19-0892 Issued:4/15/2019 Address:230 Columbia Dr Unit #314
Permit Type: MSC Cape Canaveral FL, 32920
Cost: 2500.00 Total Fees: 194.00
Amount Paid: 184.00 Date Paid: 4/15/2019
CONTRACTOR INFORMATION
Name:
Addr:
Phone:
State Lic#:
Local Lic#:
BP -Main: 80.00
BP -Surcharge: 4.00
Plan Revision Fee: 30.00
Date Plan Revision Fee Paid:
Temp CO:
Concurrency:
PERMIT EXPIRATION DATE: 10/12/2019
._OWNER: INFORMATION-.;
Name: Jon Windhorst, Trustee
Address: PO Box 540640
Merritt Island FL, 32954
Phone: (321) 806-8599
'APPLICATION .FEES-.
BP -Plan: 0.00
Fire Plan Review: 0.00
Plumbing:
Electrical:
Capital Expansion:
After the Fact: 80.00
Re Inspection Fee Paid: 0.00
Mechanical:
Sewer Imapct:
Sewer Tap:
INSPECTIONS'(for complete .list of -required inspections refer :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.
1
Permit Desc: REPLACE KITCHEN CABINETS
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 & DatO
ORIZED SIGNATURE / DATE'
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Print =� .� O (13 \ `� (2-31-
- PRINT NAME
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ISSUED / DATE
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City of Cape Canaveral
100 Polk Avenue, Cape Canaveral, FL 32920
Phone (321) 868-1220 Fax (321) 868-1247
buildingforms@cityofcapecanaveral.org
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Application Fee: $30.00
Permit#9 018(1; racking #:T V App. Date: l'
APPLICATION FOR BUILDING PERMIT
Florida Building Code in effect: 6th Edition
Total:
APR 15 2019
Property Information
TWP: RNG: SEC: SUB#: BLK/PAR: LOT:
Site Address: 7230 COL Dte *314 1 Cc e ux. .1 329Z0
Owner Name: :r -h 1v 1 )--I I� t.)12 --ST i ]j Phone:P�-32 I — — 8175-9
"1L
Owner Address: Po & gcL4 l �esfi�l 1Skv,3 i R, ';25Sor-
Contractor Information (Applicant)
Qualifier Name:
Qualifier Address:
Company Name:
Phone:
Email:
Fax:
License:
Project Information (Applicant)
)(Residential 0 Commercial Site Plan #:
Describe Work to be Done:
Pee\4.04:9 -e)6)41:9 1444640)„ COb' > els writ, we, c i,6.4 5
191)
Cost of Project: $ C CR V
(copy of contract required)
Proposed Sq. Ft.: [ DO
(total new construction)
Subcontractor Information
First & Last Name (Print) License Phone
Plumbing
Electrical
HVAC
Roofing
Specialty
City of Cape Canaveral Building Permit Application — 04/2019 Pg. 1
Site Address: 231---'- �l bi �� *-3 t 4`, Ca C ►ter J ,
�1
Owner Name: 01s.N (Ai 1 is_ 0 S+
WARNING TO OWNER
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE YOU
SCHEDULE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
.WITH YOUR -LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT. Initial:
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to
this property that may be found in the public records of this county or that may be required from other
governmental entities such as water management district, state agencies or federal agencies.
APPLICANT'S AFFIDAVIT
Application is hereby made to obtain a permit to do the work and installations as indicated. I acknowledge
and accept responsibility for compliance with all applicable codes, regulations and ordinances as well as the
payment of all legally constituted fees regarding this development application, including but not limited to
ALL REVIEW FEES, PERMIT FEES, IMPACT FEES AND RESERVATION FEES.
Contractor Name (Print):
Contractor Name (Signature):
Owner/Agent (Owner Builder Only) -(Print): TOvt wi›,J1lo-rCf.
Owner/Agent (Owner Builder Only) (Signature): �. h
Date: 1G r ) 9"
State of Florida, County of Brevard
Subscribed and sworn t before me this / da o�A_ _I
personally appeare �Ts�t,sL.0 1,L)
Ot. .20 N.
/
p y ppwho is personally known to me or
produced 1 as identification, and who did/did not take an oath.
Notary Public Signature/Seal:
KAREN NSON
MY COMMISSION II FF 951009
EXPIRES: January 18, 2020
Bonded Thru Notary public Underwriters
DISCLAIMER: The City of Cape Canaveral's approval of this development permit does not create any right for the permittee to obtain a permit from
a state or federal agency. Further, pursuant to section 166.033, Florida Statutes, the City of Cape Canaveral shall not be liable for issuance of this
development permit in the event a permittee fails to obtain any other required approval, fails to fulfill obligations imposed by a state or federal
agency, or undertakes actions that result in a violation of state or federal law.
The issuance of this development permit is expressly conditioned upon the permittee obtaining all other applicable state or federal permits, if any,
prior to the commencement of the development authorized by the City's development permit.
FINAL INSPECTION IS REQUIRED — Failure to obtain a final inspection may result in penalty.
City of Cape Canaveral Building Permit Application — 04/2019 Pg. 2
City of Cape Canaveral
100 Polk Avenue, Cape Canaveral, FL 32920
Phone (321) 868-1220 Fax (321) 868-1247
buildingforms@cityofcapecanaveral.org
OWNER/BUILDER APPLICATION FOR CONTRACTOR EXEMPTION
Florida Statutes 489.103 Exemptions.
7) Owners of property may act as their own contractor and provide direct, onsite supervision themselves
of all work not performed by licensed contractors:
a) When building or improving farm outbuildings or one -family or two-family residences on such
property for the occupancy or use of such owners and not offered for sale or lease, or building or
improving commercial buildings, at a cost not to exceed $75,000, on such property for the
occupancy or use of such owners and not offered for sale or lease. In an action brought under this
part, proof of the sale or lease, or offering for sale or lease, of any such structure by the owner -
builder within 1 year after completion of same creates a presumption that the construction was
undertaken for purposes of sale or lease.
b) When repairing or replacing wood shakes or asphalt or fiberglass shingles on one -family, two
family, or three-family residences for the occupancy or use of such owner or tenant of the owner
and not offered for sale within 1 year after completion of the work and when the property has been
damaged by natural causes from an event recognized as an emergency situation designated by
executive order issued by the Governor declaring the existence of a state of emergency as a result
and consequence of a serious threat posed to the public health, safety, and property in this state.
This subsection does not exempt any person who is employed by or has a contract with such owner and
who acts in the capacity of a contractor. The owner may not delegate the owner's responsibility to directly
supervise all work to any other person unless that person is registered or certified under this part and the
work being performed is within the scope of that person's license. For the purposes of this subsection, the
term "owners of property" includes the owner of a mobile home situated on a leased lot. To qualify for
exemption under this subsection, an owner must personally appear and sign the building permit application
and must satisfy local permitting agency requirements, if any, proving that the owner has a complete
understanding of the owner's obligations under the law as specified in the disclosure statement of this
section. If any person violates the requirements of this subsection, the local permitting agency shall
withhold final approval, revoke the permit, or pursue any action or remedy for unlicensed activity against
the owner and any person performing work that requires licensure under the permit issued. The local
permitting agency shall provide the person with a disclosure statement.
Owners violating the above shall be subject to a penalty under Florida Statute 455.228 and may be
issued a citation and/or civil penalty.
Initials:
City of Cape Canaveral Owner/Builder Application for Contractor Exemption Application — 12/2018
Pg. 1
DISCLOSURE STATEMENT
Florida Statute 489.103(7) requires all owners of property acting as their own contractor to complete the
following disclosure statement. This is an affidavit for owner/builders applying for building permits under
the owner/builder contractor exemption.
1. I UNDERSTAND that state law requires construction to be done by a licensed contractor and have
applied for an owner -builder permit under an exemption from the law. The exemption specifies that I,
as the owner of the property listed, may act as my own contractor with certain restrictions even though
I do not have a license.
2. I UNDERSTAND that building permits are not required to be signed by a property owner unless he or
she is responsible for the construction and is not hiring a licensed contractor to assume responsibility.
3. I UNDERSTAND that, as an owner -builder, I am the responsible party of record on a permit, I
understand that I may protect myself from potential financial risk by hiring a licensed contractor and
having the permit filed in his or her name instead of my own name. I also understand that a contractor
is required by law to be licensed in Florida and to list his or her license numbers on permits or contracts.
4. I UNDERSTAND that I may build or improve a one -family or two-family residence or a farm
outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The
building or residence must be for my own use or occupancy. It may not be built or substantially
improved for sale or lease. If a building or residence that I have built or substantially improved myself
is sold or leased within 1 year after the construction is complete, the law will assume that I built or
substantially unproved it for sale or lease, which violates the exemption.
5. I UNDERSTAND that, as the owner -builder, I must provide direct, onsite supervision of the
construction.
6. I UNDERSTAND that I may not hire an unlicensed person to act as my contractor or to supervise
persons working on my building or residence. It is my responsibility to ensure that the persons whom I
employ have the licenses required by law and by county ordinance.
7. I UNDERSTAND that it is a frequent practice of unlicensed persons to have the property owner obtain
an owner -builder permit that erroneously implies that the property owner is providing his or her own
labor and materials. I, as an owner -builder, may be held liable and subjected to serious financial risk
for any injuries sustained by an unlicensed person or his or her employees while working on my
property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting
as an owner -builder and am aware of the limits of my insurance coverage for injuries to workers on my
property.
8. I UNDERSTAND that I may not delegate the responsibility for supervising work to a licensed
contractor who is not licensed to perform the work being done. Any person working on my building
who is not licensed must work under my direct supervision and must be employed by me, which means
that I must comply with laws requiring the withholding of federal income tax and social security
contributions under the. Federal Insurance Contributions Act (FICA) and must provide worker's
compensation for the employee. I understand that my failure to follow these laws may subject me to
serious financial risk.
Initials:
C
City of Cape Canaveral Owner/Builder Application for Contractor Exemption Application — 12/2018
Pg. 2
Ss
9. I AGREE that, as the party legally and financially responsible for this proposed construction activity,
I will abide by all applicable laws and requirements that governowner-builders as well as employers.
I also understand that the construction must comply with all applicable laws, ordinances, building
codes, and zoning regulations.
10. I UNDERSTAND that I may obtain more information regarding my obligations as an employer from
the Internal Revenue Service, the United States Small Business Administration, and the Florida
Department of Revenue. I also understand that I may contact the Florida Construction Industry
Licensing Board at (850) 487-1395 or www.mvfloridalicense.com for more information about licensed
contractors.
11. I AM AWARE OF, AND CONSENT TO, an owner -builder building permit applied for in my name
and understand that I am the party legally and financially responsible for the proposed construction
activity at the following address. ` �^
Property Address: * —70 G)ic.9,rv.0);,1 pater C p�
, 3�5-Z0
1
12. I AGREE to notify the City of Cape Canaveral Building Department immediately of any additions,
deletions, or changes to any of the information that I have provided on this disclosure.
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who
does not have a license, the Construction Industry Licensing Board and the Department of Professional
Regulation may be unable to assist you with any financial loss that you sustain as a result of a complaint.
Your only remedy against an unlicensed contractor may be in civil court. It is also important for you to
understand that, if an unlicensed contractor or employee of an individual or firm is injured while working
on your property, you may also be held liable for damages. If you obtain an owner -builder permit and wish
to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly
licensed and the status of the contractor's worker's compensation coverage.
Before a building permit can be issued, this disclosure statement must be completed and signed by the
property owner and returned to the local permitting agency responsible for issuing the permit. A copy of
the property owner's driver license, notarized signature of the property owner, or other type of verification
acceptable to the loca;'tting agency is required wh the pe ' >s issued.
Owner/Builder Signature:
Subscribed and sworn to b
personally appeare
produced,
Notary Public Signature/Seal:
Date: 1 2O
this ! l J ay of . 20
c51S- w o is personally known to me or
.4 as identification, and who did/did not take an oath.
:Qye KARENrIIJTCHINSCN
MY COMMISSION it FF 951009
EXPIRES: January 18, 2020
%q''' Bonded Thru Notary Public Undenvritcrs
City of Cape Canaveral Owner/Builder Application for Contractor Exemption Application — 12/2018
Pg. 3