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Home My WebLink AboutBLDG PERMIT #8249 (appl.)C, CITY OF CAPE CANAVERAL Tracking # BUILDING PERMIT APPLICATION Permit #_ 8249 (321) 868 -1222 City of Cape Canaveral Building Department 7510 N. Atlantic Ave. Cape Canaveral, FL 32920 You may download this application: www.cityofcapecanaveral.org. 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 permit, unless indicated otherwise by affidavit. I.D. may be required) Address of Job Site: 1-2 7/--Z 4 eA C '{' Zoning classification: Flood Zone: Legal description of property: Tw.N: RNG: SEC: SUBD: BLK: LOT: PB: PG: _ Property Owner Name: , ± (-1 .,f u— e Cc H Phone: Address: :2 L-2, a ri r a c rj- Fee Simple Titleholder's Name (if other than owner): Address: Bonding Company: Address: Mortgage Lender: Address: Architect/Engineer Name: Address: Type of permit Brief description of work: et C Const. Type (IA, VB, etc) Building FPL lines currently available to serve this property? Yes/No City Sewer available to serve this property? Yes/No Electrical # of stories J # of dwel- ling units Plumbing # of water closets Valuation of work (Copy of Contract Required) 00 � �� Mechanical ommercial State License No.: Phone (office): Other Fax: Architect/Engineer Name: Address: Type of Building g (please indicate as applicable) Square eet under roof Const. Type (IA, VB, etc) Occ- upancy Group (B,RI, etc.) FPL lines currently available to serve this property? Yes/No City Sewer available to serve this property? Yes/No Will this structure have built -in gas appliances? Yes/No # of stories J # of dwel- ling units # of bed- rooms # of water closets Valuation of work (Copy of Contract Required) 00 � �� Name of Company: ommercial State License No.: Phone (office): Phone (cell/pager.): Fax: Plumbing Contractor Name: Address: Name of Company: State License No.: Phone (office): Phone (cell/pager.): Fax: Mechanical Contr ctor Name: -T Bz a- Address:�'� 32 w y Y C $ zv J-4"' r SFR Phone (cell/pager.): Fax: Specialty /Other Contractor Name: Address: Name of Company: State License No.: Phone (office): Phone (cell/pager.): Fax: -Vn o ,g €iOn . .. _ 1h. 12 20`1 $ Townhouse $ Apartment $ Condomini $ Other I $ 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 (cell/pager.): Fax: Plumbing Contractor Name: Address: Name of Company: State License No.: Phone (office): Phone (cell/pager.): Fax: Mechanical Contr ctor Name: -T Bz a- Address:�'� 32 w y Y C Name of Company: ✓i zv J-4"' r State License No.: C G fz Y/,;) Phone (office): Phone (cell/pager.): Fax: Specialty /Other Contractor Name: Address: Name of Company: State License No.: Phone (office): Phone (cell/pager.): Fax: -Vn o ,g €iOn . .. _ 1h. 12 20`1 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 2007 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 and that he /she is an authorized agent of the Contractor /Owner and has the authority to apply for this permit. Applicant's Name: ��" r Lfi``�� Applicant's Signature: Date: °�°� �� Site Address: / �� C �T' For Notary use only: State of Florida, County of Brevard Sworn and subscribed before me this a;2 day of �v6gv5 , 20 by A5 141;6 Printed name of Applicant wfroduced identification: E is pe 8.1A 0eyX. s JOY UM MDI _.. .3 W COMMISSION N EE 094753 Seal: , , ftded rnN Noi* g 3 nde tters or Signature - Notary Public At Large - ';:. >i< r Fca,. >.. t:z:asi; i, �:; ,_ , rw3 This form may be duplicated. ow J Building Permit Application Checklist Notes Completed Permit Application Current code edition: FL Bldg. Code 2007 (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 $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 A earance Board A royal 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 Primary Contractor's State License Record will be kept on file after initial submittal Subcontractor's State License Authorizations: 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 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 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 must indicate person responsible for calculations Lot Draina a Surve Four sets of Fire S ression/S rinkler /Alarmspecifications 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 2007 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 and that he /she is an authorized agent of the Contractor /Owner and has the authority to apply for this permit. Applicant's Name: ��" r Lfi``�� Applicant's Signature: Date: °�°� �� Site Address: / �� C �T' For Notary use only: State of Florida, County of Brevard Sworn and subscribed before me this a;2 day of �v6gv5 , 20 by A5 141;6 Printed name of Applicant wfroduced identification: E is pe 8.1A 0eyX. s JOY UM MDI _.. .3 W COMMISSION N EE 094753 Seal: , , ftded rnN Noi* g 3 nde tters or Signature - Notary Public At Large - ';:. >i< r Fca,. >.. t:z:asi; i, �:; ,_ , rw3 This form may be duplicated. ow J IL' TOM HOSKINS' Air Conditioning, Inc. P.O. Box 320446 COCOA BEACH, FL 32932 -0446 (321) 799 -1073 Lit. #CACO 50412 TO ............... .... ... ........... h..................._c.... CC............................. ............................... TERMS l � OATS........./ ........ ............................... JOB NO......................... ............................... JOB NAME ........._P........._7/ 1.. ...a' ................. ...... ... . .. JOB LOCATION Thank You