HomeMy WebLinkAboutBLDG PERMIT #18-0111 (Insulation & drywall) Units #6-1 & #8-1City of Cape Canaveral, Florida
Building Permit
PHONE: 321-868-1222 INSPECTIONS & FAX: 868-1247
PERMIT #18-0111
CUSTOMER #007531
Vic',, a k _PERMIT INFORMATION 4
'F= i'LOCATj`ONINFORM`ATIO-N E" j
�h K r
_.,d_
Permit #: 18-0111 Issued: 11/16/2017
Address:7605 Ridgewood Ave Unit #6-1 & 8-1
Permit Type: MSC
Cape Canaveral FL, 32920
Cost: -0.00 Total Fees: 0.00
PERMIT EXPIRATION DATE: 5/15/2018
Amount Paid: 0.00 Date Paid:
i CONTRACTORlNFORMATION ''� Y
7� FA ''
01NNER(NFORIVIi4T10N�; t �_t'"
Name: AEZ Construction Inc
Name: Ridgewood Condominiums
Addr: 2425 S Courteny Pkwy
Address: P.O. Box 510842
Merritt Island, FL 32953-
Mellbourne Beach FL, 32951-0842
Phone: (321)917-5477.
Phone: (321) 784-8660
State Lic#: CBC050100
Local Lic#:
�.- s
E r . APPLICATIONxFEES
BP -Main: 0.00 BP -Plan: 0.00 After the Fact: 0.00
BP -Surcharge: 0.00 Fire Plan Review: 0.00 Re Inspection Fee Paid: 0.00
Plan Revision Fee: 0.00 Plumbing: Mechanical:
Date Plan Revision Fee Paid: Electrical: Sewer Imapct:
Temp CO: Capital Expansion: Sewer Tap:
F INSPECTIONS (for complete Ilst of required inspections-refer;to HardfCard)„M t>`
=F .�
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: HURRICANE IRMA DAMGE. NO FEE PERMIT. REPLACE INSULATION & DRYWALL IN UNITS #6-1 AND #8-1. Value
of the job $17,600.00; cost of the permit $268.31.
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.
t
Sign &Date
AUTHORIZED SI ATURE / DATE ISSUED / DATE
Print —► 1� O , _
PRINT NAME
Dater /��5 �� CITY OF CAPE CANAVERAL Tracking '#
RECEIVED BUILDING PERMIT APPLICATION. Permit# Otu
NOV 0 9 2017, (321)868-1222
City of Cape Canaveral Building Department - P.O Box 326 - 110 Polk Avenue -Cape Canaveral, FL 32920
You may download this application: wwµ.citynfeaecahaveral.ore. 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=Builder is required to sign for the buildiing peItt it;pnlleesssiindicated o1he Ise by affidavit. 'l.D. may be required)
r1
1
lull .�
Address of. Job Site: %6 O.7 .� �0oo//1vE e',gw,5p/L29��Qning classification: Flood Zone:
Legal description of property: TWN: `i RNG: 3 2 SEC: 023 SUBD: C G BLK: 9 LOT: 70d' PB: J' PG: 71s'
Property Owner Name:.C7/ 6uiopo��'�r/ l/,u, /��1�,;¢ r, d,y Phone: v'�/- 7��/-
Address: 7 Gy -Y �2 , '6 F ztlo o al 9z
Fee Simple Titleholder's Name tiro neru,an owner): Address:
Bonding Company: Address:
Mortgage Lender: Address:
,f Type of Permit Brief description of work:
Building -
Electrical `
Plumbing
Mechanical
Other e
Type of
Square
Const.
Occu-
FPI, lines
City Sewer
# of
# of # of
# of
# of
�! Building
Feet
Type
pancy
current) Y
available
.Concrete/
stories Hw•el-
bed-
Valuation of work
water
(please
under
(IA,
Classifica
available to
to serve
,asphalt
ling
rooms
closets (copy orcontran Pt quind)
indicate as
roof
VB,
-tion
serve this
this
Parking
units
State License No.:
Phone (office): _
etc)
(BALR3
property?
property?
Spaces
Address:
applicable)
State License No.:
etc.)
Yes/No
Yes/No
Specialty/Other Contractor Name: ZFIC� b w i r.u.s -v Name of Company:29;e_<
Address: �3�7 �% f�V 0*' Ads, .9/Jy ( V ZV
3,2 1J7 d
Commercial
'State Licen_se`No'`'f/8Dr77tJ�7a'D�/9D
Ptione (of Ice):
Phone (cell/pager.):
Fax:
,r
$
SFR
a
ownhouse
$ =
partment
ondominiu"
1 "d
"opt! v
YZ3
t gS.
1Z 7
,2 7
$ /7 to PO
then
$
Architect/Engineer Name:
Name. of Company:
Address:
State License No.:
Phone ('office)`
Phone (cell/pager.):
Fax:
Primary Contractor Name: Name of Company: A7 e Z. e
Address: 6f 91J,5- V, C'Oct 2iF.v�
y ,�cci
J>��;Z. �.— �s/�iri_ �`/
3� 9✓_j
State License No.: C& gW to o
Phone ('office):.3-1/-V7-"77 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 CoritractoT Name: ' '
Name of Company:
Address:
State License No.:
Phone (office):
Phone (cell/pager.):
Fax:
Specialty/Other Contractor Name: ZFIC� b w i r.u.s -v Name of Company:29;e_<
Address: �3�7 �% f�V 0*' Ads, .9/Jy ( V ZV
3,2 1J7 d
1.
'State Licen_se`No'`'f/8Dr77tJ�7a'D�/9D
Ptione (of Ice):
Phone (cell/pager.):
Fax:
,r
Building Permit Application Checklist ,.
Notes
Completed Permit Application
Current code edition: FL Bldg. Code Fifth. Edition (2014)
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-.0. Unless job is remodeling
Court Im act Fee receipt
May be deferred until C.O.
Capital Expansion Impact Fee receipt
Maybe deferred until C.O.
Sidewalk Im act 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 change out
Current Cert. Of Liability Ins./Worker's Comp. Policy / Exemption
Record will be kept on file after initial submittal
Community Appearance Board Approval
For all work visible from Public Right -Of -way
Plannin .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
Subcontractor's Authorizations:
State License
Record will be kept on file after initial submittal
Notifj, Building Department of contractor changes
Plumbing Contractor Plumbing Contractor
Electrical Contractor Electrical Contractor
Mechanical Contractor Mechanical Contractor
Roofing Contractor Roofing Contractor
Swimming Pool Contractor Swimming Pool Contractor
Gas Contractor Gas 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
Truss layout and reaction summary
Cut sheets and shop drawings will be needed at time of inspection
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 must indicate person responsible for calculations
Lot'Drains a Survey
Four sets of Fire Suppress ion/Srinkler.!Alarm specifications
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
Buildine; Code 5th 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 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*
Applicant's Name:�/ Applicant's Signature: /
Date. 7 Site Address:
For Notary use only: State of Florida, County of Bre yard I
Sworn and subscribed before me this t[4*' day of et1 , 20L'Z, by M telt4 a rmn1o.S
Printed name of Applicant
Bwho.produced identification: or
is personally known to me:
o�tA!!u, JEAN DIAZ
Seal: UY00W tecc 072425
Signature - N i DBEs: Febntary 2S 2021
0
This form may be duplicated.
�'e" Flop Bonded Thru &&ie(Notaiy Services
City of Cape Canaveral
RE: HURRICANE IRMA STORM DAMAGED PROPERTY — Property damaged as a result of
Hurricane Irma is eligible for free permitting by the City of Cape Canaveral
I hereby certify I am the owner/owners agent of property located at �� v �:z• �' �rv�d����� C.�j����1
and the work associated with Building Permit # related to damage cause
by Hurricane Irma.
I understand that by so attesting, there will be no permit fees.
-C ' I e-C;'G / 19 Z
Applicants Print
Applicants Signature
MAMYNA RIGERMAN
* * MY COMMISSION 0 FF 915690
EXPIRES: Septamber 20, 2019
'�'a e►� Bonded Tpru Budge} Nohry germs
OATH
Before me, ` ' ' a Notary
Public in and for County,
State of rz, I- , personally appeared
2,`c - b G- Z- and he being first duly
sworn by me upon his oath, says that the facts
alleged in the foregoing instrument are true.
(SEAL) (Signed) Q
Notary 6b6c
Mailing Address: P.O. Box 326 Physical Address: 110 Polk Avenue
Cape Canaveral, FL 32920-0326
Telephone (321) 868-1222 — Fax (321) 868-1247
w,A,w.citvofcanecanave.ral.nrpr e-mail- infnnnitvnfnaneranaveral nro
D /.s/� CITY OF CAPE CANAVERAL
y: ,
RECEIVED - BUILDING PERMIT APPLICATION
Tracking # . 3
OL -
Permit # I �—' W ) I
NOV 0 9 2017! (321)868-1222
City of Cape. -Canaveral Building Department - P.O Box 326 - 110 Polk Avenue - Cape Canaveral, FL 32920
You may download this application: www.citvofcai)ecaiiaveral.org. You may fax to: (321)868-1247. All applications must include the
backside of this form and 2 sets.of suppoi-ting'documents. Important: Please complete the checklist on the back of this form and provide
other docuntentation 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:Btiilder is -required-to sign forthebuilding permit. unless indicated otherwise by affidavit. I.D. may be required)
Address of Job Site: Zoning classification: Flood Zone:
Legal description of property: TWN: -2 '' RNG: 3 % SEC: 1,3 SUBD: 6*65, BLK: LOT:. 7,�5/ PB: J' PG: 7i9
Property Owner Name: 11�1/ az,, Phone: o.
Address: 7 Cy S f
Fee Simple Titlehoader's Name, (ifother than owner): Address:
Bonding Company: Address:
Mortgage Lender: Address:
Type of Permit Brief description of work:
Building _
Electrical
Plbfnbin-
Me"chanical
Other
Type Of_
Square
Const.
Occu-
FPI, lines
City sewer
# of # of
# of
# of
# of
Valuation of work
Building
Feet
Type
pancy
currently
available
Concrete/ stories
dwel-
bed-
water
(Copy of Conten Required)
_
under
(IA,
Classifies
available to
to serve
Asphalt
ling
rooms
closets
Fax:
(please
roof
VB,
tion
serve this
this
parkinl*� 3i ��i'e
ra
State License No.:
Phone (office): _
Phone (cell/pager):
Indicate as
Mechanical -Cor tfr"r!Name '` -
etc )
(B.Rl,R3
properh'?
prbpert}•?
Spa -1T" FOR ;
NJ
t'T1 �I
State License No::
Phone (office):
applicable)
Fax:
Specialty/Other contractor Name: ZEIc� �' w�i/r.�.s� •'<�
etc:)
Y;estNo
Yes/No
' State Licensi No''' /dCJptJ�a'D�/QD.
Phone (of ice): _ ,jl--j!V /e/t// Phone (cell/pager.):
Fax:
Commercial
R1 i t
$
SFR
.t,
t
Townhouse
-nv loni state or f. 'er! c:
o cii ,ecce ar
ta> .
$
partment
$
ondominiu
�'��'� v
/ZS
`. �S.1Z
7
0.2
$
ther
$
Architect/Engineer-Name:
Name of Company:
`
Address:
State License No.:
Phone (office):
Phone (cell/pager.):
Fax:
Primary Contractor Name: `lie-il1.7t'L
Name of Company: .4.5 Z <vUs7�u�:'�04/ -tie
Address: a SIJ.5_ V, CCC is if,y�X
i= /
3v< 9 ✓--i
State License No.: c/;,- 050io. o
Phone ('office):)-�/- 417- .�/7 7_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 Companv:-
Address:
-
State License No.:
Phone (office): _
Phone (cell/pager):
Fax:
Mechanical -Cor tfr"r!Name '` -
IN.of Company:
Address:
State License No::
Phone (office):
Phone (cell!pager.):
Fax:
Specialty/Other contractor Name: ZEIc� �' w�i/r.�.s� •'<�
Name of Company: Z9.eE
?y�w�/1 Fy, s/• �f c�'�i�
Addr`es '_i �7 V DPeili G'� /�/ " d-2 3.2 fJ
' State Licensi No''' /dCJptJ�a'D�/QD.
Phone (of ice): _ ,jl--j!V /e/t// Phone (cell/pager.):
Fax:
City of Cape Canaveral
ANNUAL AUTHORIZATION FORM
City of Cape Canaveral Building Department / 110 Polk Ave, Cape Canaveral, FL 32920
Office: (321) 868-1222 / Fax: (321) 868-1247
DATE: �✓* V, 2 0(-4
(You may download this authorization form: www.cityofcapecanaveral.org)
CONTRACTORS & SUB -CONTRACTORS — PLEASE HAVE YOUR SIGNATURE NOTARIZED
Company Name: XC Z— - C_S-k , jy1 C �
C11 -al ( VW k(M K l O S , hereby authorize the person(s) below to obtain a permit
on my behalf under my state license(s) as issued by the Department of Business and Professional
Regulation, Construction Industry Licensing Board (state License Number)
This Authorization will be good for one calendar year and it will be the sole responsibility of the
Contractor to inform the City of Cape Canaveral Building Department of any changes. It will be the sole
responsibility of the Contractor to renew this form annually. The City of Cape Canaveral will not be held
responsible for any permits leaving this office by any and all persons listed below while this document is
in effect. The City of Cape Canaveral will not be held responsible for renewal of this document.
2.
O 1Z- 4.
5.
M
I.D. IS MANDATORY TO RELEASE PERMITS
SIGNATURE OF LICENSE HOLDER: �!! / /
PRINTED NAME OF LICENSE HOLDER: Nfc-/�� / (4O -j ( [ W tA 1 O S
For Notary Use Only: State of Florida, County of Brevard
Sworn and subscribed before me this day ofU^i'-, 206-1 G2,tit
,,, ho produced identificationr�E �y7 (( ��,Q, I �-A f r -n ri)as
v
M Personally known to me
KAREN HUTCHINSON
Seal:
MYCOMMISSION ur Notary Public At Large:—
s EXPIRES: January 18, 2020
?P� Bonded Thru Notary Public Underwriters