HomeMy WebLinkAboutBldg Permit #16-0694- 8699 Astronaut Blvd- 8/15/1608/15/16 08:55AM
FLORIDA MASTERTEMP 32163824734 II. 00p.02
'Date: (R ` rrr' /ti CITY OF CAPE CANAVERAL Tracking # 1 L_
RECEIVED BUILDING PERMIT APPLICATION Permit # 1110 — ( O ct (i --
AUG 15 2016 (321)868-1222
City of Cape Canaveral Building Departntcnt - 7510 N, Atlantic Ave. • Cape Canaveral, FL 32920
You may download this application: www.cityok, catlpvu;}l,,gng, You may fax to: (321)868-1247. MI 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 fi>r the building permit, unless incilc:nted otherwise by affidavit. 1.1), may be required)
Address of,Iob Site: .2 a t f 0 nck.o.LILS Zoning classification: Flood Zone:
Legal description of property: •rwN: MO:.--,„,„„„�, SIX: .•.___• SLIBD: .__ _ aLK: LOT; P13, PG: �_
Property Owner Name: lir ic.4 5 , .s,j.5rc.a_ — __ _ ._._� Phone: IP t »- - t _ _
Address: J 3�3 &r iO 1, W W. !.r)C.vc.mm. ; . , N''e . . '3;93
Fee Simple Tit:leholder's Name (if den- dam owncr): Address:
Bonding Company:
Mortgage Lender:
Address:
Address:
4
Type of Permit
Brierdescription of work:
Coast,
Type
(EA,
VE3,
etc)
()eel,-
pane),
t::tassifica
•tk»
(13,R1,R:3
etc.)
II
Buildin,
I of
Concrete/
Asphalt
Parking
Splices
P
)i or
storica
1i or
dwel.
ling
unit.$
WI
411
M
Electrical
nun t_jin.g_
Mechanical
Volution of work
(copy or Connaf Room')
Fax• __ ~^
” $ /On laic.
to
Electrical Contractor Name: Name of Company:
)Cr,' 41L+.z
Other
' /
Type of
Building
(please
indicate as
applicable)
.onnnercial
square
Feet
under
root
Coast,
Type
(EA,
VE3,
etc)
()eel,-
pane),
t::tassifica
•tk»
(13,R1,R:3
etc.)
PPL tines
currently
available to
serve this
property?
Yes/No
City Sewer
available
19 serve
this
property':
Yes/No
I of
Concrete/
Asphalt
Parking
Splices
P
)i or
storica
1i or
dwel.
ling
unit.$
$0 or
bed,.
rooms
If or
water
Closets
Volution of work
(copy or Connaf Room')
Fax• __ ~^
•,„
,,,;
Electrical Contractor Name: Name of Company:
Address:
12190.00
Fax:
!'lambing Contractor Nan►e:.. . ...... Name of Company;
.----, .-
Address: ..�_ .�.............,..W.....w....,,...�w,..
�_._._ ..... _ __ _ ___ _ e
..
_..._.......,._.
State License No.: Phone (office), Phone(cell/pager.):
�..�.._�...____.............._ ...............,�-.,.,_
Fax:
_ _
Mechanical Contractor Name:t mobs_- - . • - Name
ame of Com1pany: -
yr
Townhouse
........._._r
(" S,j5.Pi4`,2
....._______State License No.:t l,e ly-.-„, Phone (office): , 1--,3'-,& le
(cell/pager.);
..,,,.n.H;(k
..,,.,
Fax: 32ta_aJI
._, ."
Specialty/Other Contractor Name: Name of Company:
'”
$
Apartment
State License No.; _. Phone (office): ___�__ !'hone (cell/pager.);,,-__,
Pax:
$
Condominium
$
Other
$
Architect/Engineer Name: Nance of Company:
_
.... •
Address;
State License No. _____L__„,,,.___ Phone ((sifice): ,.mm j'hone (cell/pager.): ___
w-
... Fax: _
Primary Contractor Name: Name of Company:
_
Address;
State License No,: Phone (office): Phone (cell/pager.):
Fax• __ ~^
•,„
,,,;
Electrical Contractor Name: Name of Company:
Address:
State License No.: _ Phone (office): Phone (cell/pager.):
Fax:
!'lambing Contractor Nan►e:.. . ...... Name of Company;
.----, .-
Address: ..�_ .�.............,..W.....w....,,...�w,..
�_._._ ..... _ __ _ ___ _ e
..
_..._.......,._.
State License No.: Phone (office), Phone(cell/pager.):
�..�.._�...____.............._ ...............,�-.,.,_
Fax:
_ _
Mechanical Contractor Name:t mobs_- - . • - Name
ame of Com1pany: -
yr
....?4"15 N' ..W,�..i......9. _LXOL l4
........._._r
(" S,j5.Pi4`,2
....._______State License No.:t l,e ly-.-„, Phone (office): , 1--,3'-,& le
(cell/pager.);
..,,,.n.H;(k
..,,.,
Fax: 32ta_aJI
._, ."
Specialty/Other Contractor Name: Name of Company:
Address:
State License No.; _. Phone (office): ___�__ !'hone (cell/pager.);,,-__,
Pax:
08/15/16 08:55AM FLORIDA MASTERTEMP 3216382473
p. 03
.�.,,
Building i'ermit Aiglestien
Checklist
Notes
Current code edition; FL Bldg, Code 2010 (as revised)
Completed Permit Application
Current survey showitmailm
s5ec1 construction land landscl;pina
Affidavit mmmm�mm�
_
+C,•he k with Bldg^ beet for setbacks MWw.Y—„,�K._ _
ifowner is actiitit as contractor
Notarized signature - Owner/Builder
Sewer Impact free r(ceij
May he deferred until C.O. Unless job is remodeling
County Impact Fee receipt
May be dctcrred until Co.
Ca )italItix lausion !mew Fee
recei
of
A
Pim
)t
”--. "µw"w
Ownership
over $? 50U
Corn . Pplicy / 1~xem lion
roust
Approval —
Maybe deferred until C.O.
If sidewalk exists on lot
_.............,.. WWW.,..,.........................�.,...W.,.—,..W.—,.,...W.......�w....,�....�"
Sidewalk int actPoe receipt »..,.....w...WW.�.............w,....,..
Recorded Warranty Deed / Proof
Copy of Recorded Notice of C:omme•ncement
Over $7,500 I'or Mechanical change out
Record will be kept on tile tfeririitial submittal
—.-----.—
Irtr all work vi ible from }Mille Egitt-Of-Woy
Current Cert. Of Liabilit sins /Worker's
___Spriarluspiv
A earance Board
Plannitiand Tonin Board Site
Concurrenoy.f ornia
u ...... _ _ .............
pnSlruCt unitsma -
For all 'new of Ain]. ore
For all new construction not part of nppr�>ved site plan
Record will be kept on file elleriridial submittal
Primary Contractor's State License
—+r
Subcontractor's
State License
Authorisations:
Plumbing f: ontractor
• Eicctrical Contractor—
—
Record will he kept on tile atter initial submittal
Notify Bathing Nominal of contractor changes
Plumbing Contractor
.,---.---- . ... �
------,-_---
Electrical Contractor-�'—'--
Mechanical Contractor
Mechanical Contr{rotor
Roofingr,Contractor
Rooj Contractor
Swimttrin fool Contractor
Swimmin Pont Contractor
-_�
Gas Contractor
Cias Contractor
Specialty/Other Contractor
Specialty/Other Contractor
Per F.B.C. 104
Construction Drawings:
Three sets of sealed construction drawings
Per F.B.C. 104
Truss IayyOi tinct reaction summary,
Electrical load Calculations
Cut sheets and shop drawings will be needed of time ofinsp.
Plans must indicate person responsible for calculations
Electrical Riser
All new service muse be located underground
PlumbinRiser _
Plans must indicate person responsible fir design
A/C: rout
Plans must indicate person responsible for design
Two sets of EnergyC:alcutations
Plans must indicate person responsible for calculations
Lot Drainage Survey
Four sets of Fire Suppression/Sprinkler/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
Building Code 2010 Edition, f 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 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.
*ALL OTHER APPLICABLE STATE OR FEDERAL PERMITS MUST BE OBTAINED PRIOR TO 00541 tk:NCEM> NT"
Contr'actor's Name: '� Mc; s 'f ' �'� • Contractor's Signature:
Date:
Site Address:
For Notary use only: State of Florida, County of Brevard
Sworn and subscribed before me this 15 'i`". day of All%
who pt'oduced identification: or
is personally known
ca"°,a,•,,,, HOPE M PERRY
a Notary Public • State of Rortda
Commission m FF 2311111
41, ;-� ' My Comm. Wires Aug 26, 2019,!! •:
??.41011° Poled 1LIl0UalMoral Ala I
Seal:
, 20.1 , by ;I�It� n4CR `L r iir"Y !l� )71
Printed name of Applicant
iignature . Notary Public At Large
This tbrin may be duplicated,
08/15/16
08:55AM
FLORIDA MASTERTEMP
3216382473
p. 04
"1"13i.. Pi
RTI
www a;tiridircr,•tnry:ors
Certiflcate of Product Ratin.s
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AHRI Certified Reference Number: 7653045 Date: 8/15/2016
Product; Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: NXA460GKC"
Indoor Unit Model Number: FEM4X60"81.
Manufacturer: TEMPSTAR
Trade/Brand name: TEMPSTAR
Region: Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY LA MD, M$, NC, OK, SC, TN, TX, VA
AK, CO, CT, ID, IL, IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ,
NY, OH, OR, PA, RI, SD, UT, VT, WA, WV, WI, WY, U.S. Territories)
Region Note: Central air conditioners manufactured prior to January 1, 2015, are eligible to be
installed in all regions until June 30, 2016. Beginning July 1, 2016, central air conditioners
can only be installed in region(s) for which they meet the regional efficiency requirement.
Series name.; l.d SEER N.SERIES R4lOA AC
ManufOlder::crietponifblo::ta'r•the rating ot,this'.systeM•coiitiainattonls';'>~>«i pS AR' :;:::;` :`` ::;' ;'' ;•
Rated' fo lows in accordance with AHRI Standard 210/240.2006'fdt` limitary' Air-Coriditiontxi• ' 'arig i'r+�aouroe
Heat •(Mini'p. Equipmertt•and•subjest.to verification'of.rating•accuracy'•by,AHi 1 sponsored, itigepphd@ttkthird
partYle.:0 0 • .
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,• EEFt•,';R'
�tlfi' '�•�'liolin`�
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S>wK#`tatng'(Cootlrlg)i 14:00 .• .•
IEEA Rating (Cooling):
• Relines, followed by an rauluri .k t') Indloute a voluntary range of previously published dela, vtlIess accompanied veal a WAS, which Uldicalt an Involuntary rotate.
DISCLAIMER
AHRI does not endorse the products) listed on this Certificate and makes nu representations, warranties or guarantees as to, and assumes no responsibility for,
the product(s) fisted on this Certificate, AHRI expressly disclaims ail liability 'Or damages of any kind arising out Of the use or performance of the product(s), or the
unauthorized alteratWn of data listed On this Certificate, Certified ratings are valid only ter models and configurations listed In the
directory at www.alhridlreetory.org,
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHFU, Ws Certificate shall only be used for Individual, personal and
Confidential reference purposes. The contents of this Certificate may not, in whole or In part, be reproduced; copied; disseminated;
entered WO a computer database; or otherwise utlhIa:d, in any form or manner or by any means, except for the user's individual,
personal and Confidential reference.
CERTIFICATE VERIFICATION
The Inhumation for the model cited on this certificate can be verified at www,abridirectory,org, Cl)Ck on "Verify Certificate" Zink
and anter the AHRICertified Reference Number mmol the date on which the certificate was issued,
whtrh is listed above, and the Certificate No., which is listed al bottom right, .'—"""',.e••••—•_•••—••••_••••••.••_••__—•••••••••••••,,,••,—••_..__......._.....,,
02014 Air -Conditioning, Heating, and Refrigeration Institute f CERTIFICATENO„ 13115737986M 1000,,
Alk•doN41TIUNING, NKANN%
A REFRIGERATION IttfiTI?UTE
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