HomeMy WebLinkAboutBLDG PERMIT #18-0562 (A/C)City of Cape Canaveral, Florida
Building Permit
PERMIT #18-0562
CUSTOMER #001605
DUnKIC• 271_464_17711 IAICDcrri %AIC• 271 464 IMA CAV• 271 4G4_17A7
PERMIT INFORMATIONS;
s �,�tOCATIONINFORM_ATIONs
Permit #:18-0562 Issued:2/16/2018
Address:251 Circle Dr Unit 1-4
Permit Type: MER
Cape Canaveral FL, 32920
Cost: 3200.00 Total Fees: 119.00
PERMIT EXPIRATION DATE: 8/15/2018
Amount Paid: 119.00 Date Paid: 2/16/2018
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` `'_ CONTRACTOR�`INFORMATION''
N 3 l-
'�ONi
�' OWERi�NFORMAT,I
,� • � .:.,Z _ .._ �' ,..: •-•�L . _ , :._
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Name: Tom Hoskins Air Conditioning Inc
Name: Cheryl Mason, Revocable Trust
Addr: PO Box 320446
Address: 2805 La Cita Ln
Cocoa Bch, FL 32931-
Titusville FL, 32780
Phone: (321)799-1073
Phone: (321) 243-3955
State Lic#: CAC050412
Local Lic#:
`APPLICATION FEESs ,
BP -Main: 85.00 VBP-Plan: 0.00 After the Fact: 0.00
BP -Surcharge: 4.00 Fire Plan Review: 0.00 Re Inspection Fee Paid: 0.00
Plan Revision Fee: 30.00 Plumbing: Mechanical:
Date Plan Revision Fee Paid: Electrical: Sewer Imapct:
Temp CO: Capital Expansion: Sewer Tap:
Concurrencv:
< INSPECTIONS (for,;completedlst of;;required. Inspections: ref erto,Hard;Card)
w _ -
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 TON) FOR UNIT#1
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
AUTHORIZED SIGNATURE / DATE
Print — - _'f t3 /
PRINT NAME
r
ISSUED / DATE
t — . �, 119.00
` Iu_�:�1
LFI / .+n'•.I(Ul'ti 4 L ui1�(ij
10111 ;4UK
Iffiq Ai-ount $111 i,
9.00
.' Date:,?/ 3
A?
RECEIVED
FEB 13 2018
CITY OF CAPE.CANAVERAL
BUILDING PERMIT APPLICATION
Tracking tl
Permit k i
(321)868-1222
City of Cape Canaveral Building Department - P.0 Box 326 - 110 Polk Avenue - Cape Canaveral, FL 32920
You may download this application: www.city2fcapecauaver�l,gtg. 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 oil the back of this form and provide
other documentation as indicated on the .checklist. A copy of contract inay 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 permit. unless indicated otherwise by afildavit, I.D. maybe required)
Address of Job Site: 07�- CA C (A a gr / Zoning classification: Flood Zone:
Legal description of property: Tw ; RNc: _ ,,. SSc: SUBD: BLK: LOT: PB: PG:Property Owner Name: C 2►+ -relo— Phone: •?k3— 3, Xr
Address: <-!5,1 _C44r 10 1/
Fee Simple Titleholder's Name (if Other than owner): Address:
Bonding Company: Address:
Mortgage Lender: Address:
Type of Permit Brief description of work:
Building
Electrical
Plumbing
Mechanical
Other
Type of
Square const. oecu-
PPI, lines Cit• Sewer
tl of w or M of
# of
a of
Building
Feer 'type Panty
currently available
Concrete/ stories dwel-
bed-
water Valuation of work
(please
under (IA, Classtflta
available to to serve
Asphalt NDA
roams
closets (Copy atcasttret aeq■hwe)
indicate as
roof V8, -Non
serve this this
Parking units
Phone (celUpager.):
Fax: .
applicabie)
etc) (8,Rl,R3
property? property?
-Spaces
State License No.:
3/ 0& -6
Phone (cell/pager.):
etc.)
Yes/No Yes/No
jZj,0—
Name of Company:
mmercial
Phone (office): �� 09r L7 Phone (cell/pager.):
Fax: _
Specialty/Other Contractor Name:
Address: _
State License No.:
Phone (office):
$
FR
I$
ownhouse
--
s
S
S
ptutment
ondominiu
-
er
$
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:
Name of Company:
State License No.:
Phone (office):
Phone (celUpager.):
Fax: .
Plumbing Contractor Name.
Address:
, Name of Company:
State License No.:
` Phone (office): _
Phone (cell/pager.):
Fax:
Mechanical Contractor Name: 17A
Address:
jZj,0—
Name of Company:
State License No.: _CqCr f`'f/.?
Phone (office): �� 09r L7 Phone (cell/pager.):
Fax: _
Specialty/Other Contractor Name:
Address: _
State License No.:
Phone (office):
Name of Company:
Phone (cell/pager.):
Fax:
T002 XVd Z6:TT 9TOZ/CT/ZO
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 i:lo ida
Bu' in Cod Editio . 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 inspec6on(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 PERMIT'S MUST BE OBTAINED PRIOR TO COMMENCEMENT*
Applicant's Name; ��'�e ����r Applicant's Signature: .
Date: %3 % Site Address: e;2s-CSA C 4
For Notary use only; State of Flori�ty of Brq>�ar 2 Q1 11
_
Sworn and subscribed before me this y of -fi�i . by — — L L-,
Primed name of Applicant
who produced identification: or
is personall KAREN HUTCH!NSON
t`•""n 4� = MY COMMISSION 9 r 951009 / /\
r ; y ,'` EXPIRES: January 18, 2020 ��, �� -C�
Seat: t FCS Bonded Thru Notary Public Undervriters � 5ignaNrc -Notary Public At Large
This form may be duplicated.
T0021 YVd Cis:TT 8TOZ/CT/90