HomeMy WebLinkAbout08-7473
CITY .OF ZEPHYRHILLS
5335 -18TH STREET
(813)780-0020
BUILDING ,PERMIT
Cl . Y OF ZEPi- Yi-
5335----18T~ ~ -r =-
747.3~,7f,~.f --
" . ~"~ h.<
Permit Number: 7473
Permit Type: ACCESSORY BLDG.
Class of Work: SHED INSTALLATION
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost: 3,000.00
Date Issued: 2/11/2008
Total Fees: 67.50
Amount Paid: 67.50
Date Paid: 2/11/2008
Work Desc: INSTALLATION OF 10 X 16 SHED
Address: 5436 10TH HISTORIC
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): 'Block: Section:
'Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-.,26-21-001 0-13700-0190
Phone:
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SHEATHING
FINAL
'RE!N$HCqI.Ll(i)IIIiEES:Rein~ction'feeswillcomply with Florida Statute 553.80 (2)(c) when extra inspection
mpsarel1ecessarydueto anyone of the following reasons: a) wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections called d) work not ready for
inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible.
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, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
"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 an attorney
before recording your . of co mencement."
CONTRACTOR SIGNATUR PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Date Received:
-r;:deJ/.! berlf
~ I
2-1- () p
5<130 It' ~s/
<)~A er/
Contractor/Homeowner:
Site:
Permit Type:
Approved wino comments: 0
Approved withe below comments: E1 Denied withe below comments: 0
JD :(~~ P~tPr91)~o~f:~:r~
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511 C{ ((
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This comm:'ie/hal1 be kept with the p~t and/or~../J ~
U ~ ---0 ~,L~~
Kalvin witzer - Plan mer Date Contractor and/or Homeowner
(Required when comments are present)
11111111111111111111111111111111111111111111111111111111111I
2008021002
Rcpl:1160055 Rec: 10.00
DS: 0. 00 IT: 0. 00
02/11/08 u_~_______ Dpty Clerk
NOTICE OF COMMENCEMENT
JED PITTMAN, PASCO COUNTY CLERK
02/11/08 01:33~ 1 ~/81..
OR BK 775a PG a ~
Pennit No.
. I / I 00 (0 13-700 019'0
Property Identification No.--1J ;l.. (p ~
R
THE UNDERSIGNED hereby give informs you that the improvement will be made to certain real property, and in accordance with
Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. ~~'1 ft:::,
l.Description of property (legal description:) tvl13 Pb 5 1..07$ / - -<.0 8L 137 7~3-7~?
a) Street Address: . 3 0 -r; 7, 3 ~
2.General description of improvements: + -/1
PL,q.L.-€.merv7- r/ 5-rC//'i'iOQ....l S f?,f)
3.0wnerlnformation . ... ". & ~.z . J f rz c:;
a) Name and address: 8 ra V € Yl t...j{ II" ( P ~€--71 S'if ~ Co I :> / ~-R/ h r I" 11 I / r I' 1
b) Name and address offee simple titl~holder (if other than owner)
c) Interest in property
4.Contractor Information
a) Name and address:
b) Telephone No.:
5.Surety Information
a) Name and address:
b) Amount of Bond:
c) Telephone No.:
6. Lender
a) Name and address:
3/ 61 GFU.G, 6>t-t/tJ~
. - . I Fi 33511
Fax No. (Opt.)
Phone No.
7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
8.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.13 ( 1 )(b), Florida Statutes:
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
9.Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is
specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13,
FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.
A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICEZZ O~MENCE N~. ~
STATEOFFLORI~A 'PfI. _.
COUNTY OF PAS O~~ ~ JUNE C BLEDSOE
. ~w# MY COMMISSION # 0046262!' Signature of Owner or Owner's Authorized Officer/Director/PartnerlManager
~on\.ll" EXPIRES: Aug. 17.2009 C AiD' .. J Ca.-r.J::.... ,
(407) 39~153 Florida Notary Servlce.com ~.. (V . ~t;;;" fV
Print Name
The foregoing instrument was acknowledged before me this 1!1- day of --fea .) , 20 .~~ by CftRJ-.- N
. CIt-~TE Ai as (type of authority, e.g. officer, trustee, attorney
m fact) for (name of party on behalf of whom instrument was executed).
P."onally Known V OR Pmdured Ideutifie.tiou Notary Sigo.ture j~ C- ~
J U^-J
Type of Identification Produced
Name (print)
c.
$
FORMS/NOC,rvsd2007
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Verification pm:su~nt to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read t~ fqr.e~oi1i~<)'
the facts stated m It are true to the best of my knowledge and belief. :: ,'-: . -_ ,~'. </: _
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Signature of Natural Person Signing Above
---------------/----- cri''Y~~O.FZE:pjIYRHILLS BUILDING DEPARTMENT
OWNER fJro I/'e-I" L- y -rr~ jPL (LTT
JOB LOCATION SSl3~ / cr1h ST Z "<Ph Y rid / I~
PARCEL I.D.'ff -U -~-~t-.OO/O--/3/0()-c:Q19'O c!"fJrD~(crtD<D(
snow ALL EXISTI'IG & PROPOSED STRUCl"URES GIVINGDIHENSIONS -& SETBACKS.
<:: /.pD' ~
) ~:{Jk -l
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UTILITY BUILDINGS
MUST SHOW SIZE &
FOUNDATION INFOR-
MATION.
,..--,
r\ol,\'S-=L\
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~ ------
FRONl PROPERTY LINE
(NOrnEEXAMPLES 1 & 2)
STREET
1. SETBACKS FOR Rl, R2 ZONING
60'
2. SETBACKS FOR R3 ZONING
60'
10'
P E
R X
0 I
10' P S 10'
0 T
S I
E N
D G
1 0'
10'
.
10' EXISTING 10'
110
PROPOSED
20'SGL FAM 30' DUPLEX
,--
20'
FRONT PROPERTY LINE
FRONT PROPERTY LINE
Owner's Address
Fee Simple Titleholder Namel
City of Zephyrhihs Permit Application
Building Department
Fax-813-780-0021
813-780-0020
Date Received
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/O~ 5'''-; Zr;;J.dllirhf 1('>/
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P~RCEL ID#I
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Owner Phone Number
Owner Phone Number I
Owner Phone Number I
Owner's Name
Fee Simple Titleholder Address I
6Y.3~
R
LOT #
JOB ADDRESS
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D NEWCONSTR D AqD/ALT
D INSTALL D REPAIR
i
PROPOSED USE D SFR D COMM
I
TYPE OF CONSTRUCTION D BLOCK D F~ME
DESCRIPTION OF WORK I I
BUILDING SIZE I i OX 14-- I SQ FOOTAGE I 1162 I HEIGHT I /0 /' I
'...11..1111'.111....11.......11...111....111...11......,..'...111......1.....:'.....11......,....,......111111'.......11.11..............11.......11
~ BUILDING 1$ -::z ~ 00 I I
~ ....,J/~r _ VALUArONOFTOTALCONSTRUCTION
o ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY
o PLUMBING 1$ I
D MECHANICAL 1$ I VALUApiTlON OF MECHANICAL INSTALLATION
D GAS D ROOFING D S ECIAL TY D OTHER
FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
(2~ r ~ti}'1 ~~:~~
I
SUBDIVISION
(OBTAINED FROM PROPERTY TAX NOTICE)
SIGN D MOVE D
DEMOLISH
WORK PROPOSED
D
D
D
OTHER
STEEL
I
D
OTHER I
D
W.R.E.C,
N~V
Address
I CoOle S IidlXS
I Y I N I FEE CURRENT
License # I
Y/N
BUILDER
SIGNATURE
ELECTRICIAN
SIGNATURE
COMPANY
REGISTERED
Y/N
FEE CURRENT
Y/N
License #
Y I N FEE CURRENT
License #
YI N FEE CURRENT
License #
Y I N FEE CURRENT
Address
PLUMBER
SIGNATURE
COMPANY
REGISTERED
Y/N
Address
MECHANICAL
SIGNATURE
COMPANY
REGISTERED
Y/N
Address
OTHER
SIGNATURE
COMPANY
REGISTERED
Y/N
Address License #
I
11111I1111111111111111111111111111111111111I1111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111I
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction,
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wI Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for ~Ubdivisions/large projects
Attach (3) complete sets of Building Plans plus a Life ~afety Page; (1) set of Energy Forms. R-O-W Permit for new construction.
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for ~II new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans. I
'---PROPERTY SURVEY required for all NEW constryction.
11111111111111111111111111111111111111111111111111111111111111111111111;1111111111111111111111111111111111111111I111111111111111111111111I111I11111
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (AlC upgra es over $5000)
Agent (for the contractor) or Power of Attorney (for the owner) would b someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs Sewers Service Upgrades A1C
COMMERCIAL
Fe ces (Plot/Survey/Footage)
I
Driveways-Not over Counter if on public roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions"
which may be more restrictive than County regulations. The u~dersigned assumes responsibility for compliance with any
applicable deed restrictions. I
UNLICENSED CONTRACTORS AND CONTRACTOR RESfONSIBILlTIES: If the owner has hired a contractor or
contractors. to und.ertake work, they may be required to be IiCelnsed in accordance with ~tate and local regulations. If the
contractor IS not licensed as requIred by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are unclfrtain as to what licensing requirements may apply for the
intended work, they are advised to contact the Pasco County Building Inspection Division-Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or Icontractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for which Ithey will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properly Iieensed and is not entitled to permitting privileges in Pasco
County. I
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RES<j>URCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, ab specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands, that I such fees, as may be due, will be identified at the time of
permitting. It is further understood that Transportation Impac~ Fees and Resource Recovery Fees must be paid prior to
receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prior to permit iss~ance. Furthermore, if Pasco County Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in accbrdance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes~ as amended): If valuation of work is $2,500.00 or more, I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law-Homeowner's
Protection Guide" prepared by the Florida Department of Agripulture and Consumer Affairs. If the applicant is someone
other than the "owner", I certify that I have obtained a copy Of~he above described document and promise in good faith to
deliver it to the "owner" prior to commencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all th information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a permit to do work and installatio~ as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work '?Viii be performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, an~ land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governm~nt agencies may apply to the intended work, and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
_ Department of Environmental protection-cypressll Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses. I
Army Corps of Engineers-Seawalls, Docks, Navig~ble Waterways.
Department of Health & Rehabilitative Services~Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks. I
_ US Environmental Protection Agency-Asbestos al)jatement.
_ Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
_ Use of fill is not allowed in Flood Zone "V" unless ~xpressly permitted.
If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
If the fill material is to be used in Flood Zone "If in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fi~!.the area within the stem wall.
If fill material is to be used in any area, I certIfy that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affept adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill, an engineered draihage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand I~hat a s.eparate perm~t. may ?e requir~d for elect~ica.1 work,
plumbing, signs, wells, pools, air conditioning, gas, or other ~nstallatlons not speCifically 1n~luded.1n the application. A
permit issued shall be construed to be a license to proce?d '^11th the work a~d not as authorl~y ~o vlol~t~, cancel, alter, or
set aside any provisions of the technical codes, n?r shall.lss~fnce of a permit prevent the B~II~lng OffiCial from the~eaft~r
requiring a correction of errors in plans, construction or vlolat~o~s o! any codes. Eve~ ~ermlt Issued. shall become. invalid
unless the work authorized by such permit is commenced WI hln SIX months of permit Issuance, or If work authOrized by
the permit is suspended or abandoned for a period of six (6) onths after the time th~ work is commenced: An extension
may be requested, in writing, from the Building Official for a eriod not t~ exceed n1n~ty (.90) da~s and Will demonstrate
justifiable cause for the extension. If work ceases for ninety ( 0) consecutIve days, the\Job IS conSidered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPE~TY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECO~DING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03) !
OWNER OR AGENT CONfRACTOR
Subscribed and sworn to (or affirmed) before me this Subsdrlbed and sworn to (or affinned) before me this
~ I ~
Who is/are personally known to me or has/have produced Who If' tare personally known to me or has/have produced
as identification. as identification.
Nota", Publl' ;
Commission No.
I
I
N'mlOf Nota", ""od, p""l'd ,,"'mpod
I
I
Notary Public
Commission No.
Name of Notary typed. printed or stamped
COOK PORTABLE WAREHOUSES ORDER FORM
DATE:
(Ul"l"ll..t: U~1: UNLY)
SALES PERSON:
VISTA MARKETING
CARL CASTEN
DEALER PHONE #: 813-788-5459
D~~R~X#:813-788-5459
BUSINESS NAME:
ACCOUNT:
USE DIAGRAM BELOW TO SHOW OPTION PLACEMENT
BACK
STYLE SIZE
BARN X NEW
ECONO X BLACK
WIN LOFT BAR 10 16 WHITE
X
UTILITY X CHARCOA
LEFT RIGHT L GRAY
GARAGE X LIGHT XX
BROWN
DD LOFT GAR. X
CABIN X RED
FRONT
Y CODE FOR OPTION PLACEMENcD- SINGLE DD= DOUBLE S= STEEL F= AlC G= GARAGE W-
.DOOR DOOR DOOR FRAMEOUT DOOR WINDOW
MISCELLANEOUS
PLACE DOUBLE D. ON RIGHT SIDE 4 FT. FROM
FRONT. PLACE 24X36 WIN. ON RIGHT SIDE 4 FT. FROM
BACK. THANKS.!
BEVERLY TRIPLETT
CUSTOMER NAME(S)
5436 10TH STREET
ADDRESS
HOME
~~LiK 813-782-4245
ZEPHYRHILlS FL
CITY STATE
33542 PASCO
ZIP COUNTY
HOME
WORK
CELL
NAME OF EMPLOYER
PEACOCK MEATS
DELIVERY ADDRESS IF DIFFERENT THAN MAILING ADDRESS
SOCIAL SECURITY
NUMBER
230-70-5329
MAN AT Y N ALL RT R
CITY
STATE
ZIP
cou N IT
DRIVER'S LICENSE
NUMBER
)ATE OF BIRTH
T614-070-5329
T614-070-50-524
E-MAIL ADDRESS
SALES PRICE
SALES PRICE
$2,915.00
SECURITY DEPOSIT
$100.00
DISCOUNT
DISCOUNT
SERVICE FEE
OPTIONS TOTAL
OPTIONS TOTAL
$85.00
DELIVERY FEE
$135.00
SUBTOTAL
SUBTOTAL
$3,000.00
TAX ON DELIVERY
$9.45
STATE TAX _0/0
OPTIONAL DOWN
PAYMENT
LOCAL TAX _0/0
TAX ON DOWN
PAYMENT
TOTAL DUE FOR DEUVERY
TOTAL DUEl $244.45
INGLE USE TAX (TN)
MONTHLY RENT
$151.52
SERVICE FEES
MONTHLY STATE
SALES TAX
OPTIONS
PRICE
DELIVERY FEE
MONTHLY LOCAL
SALES TAX
$10.61
TAX ON DELIVERY
TOT AL!------b-b--------------m---------------j
MONTHLY RENTL___b_______$.}_~~_._.!~_____________j
TOTAL DUEl
]
OPTIONS TOTAL
AMOUNT RECEIVED BY
DEALER
$244.45
CHECK NUMBER OR
REFERENCE NUMBER
CHECK #446
COD AMOUNT
HWY 301 NORTH TO 6TH AVE. TURN RIGHT. TO 10TH STREET. TURN LEFT.
FOR DEUVERY STATUS, lOG ON TO COOKPORTABLEWAREHOUSES.COM
HOW TO LOAD THE DOORS?
TOWARDS THE CAB
BACK OF THE TRAILER
DRIVERS SIDE XX
PASSENGERS SIDE
ALL WEATHER DEUVERY?
YES HARD SURFACE XX
NO SOFT GROUND
FOR CUSTOMER
(PLEASE PRINT)
These questions must be" answered for all orders!
Yes
No
Initials
" \f>r
1 Is there clear access to the desired delivery location?
(i.e. is the area clear of trees, overhead wires,
ditches, and enough room for a 30' trailer, etc.)
2 Will driver need to cross property other than your own?
(If Yes, the adjoining property release form must
be completed before delivery can be scheduled.)
3 Do you own the property where the building will be placed? [ill D
(If not, do you have owner's permission to place
building on the property7)** D D <.
** A signed document from the property owner granting Cook Portable Wal>ehouses or
its agent access to his property to deliver and/or retrieve the portable warehouse must
be obtained before delivery will be scheduled. ___
4 Is there a fence** around the property? D M -<.. 13 (
** Unless there is a gate wide enough to accommodate our truck ~raileras well as
the width of the building, the customer is responsible for removing the fence to allow for
> How wide is the gate opening? I I" .----
5 Will the customer be available to sign for delivery? ~ D ~ I
(If not, the customer must add an authorized person to the account before de Ivery will
be available.)
[]X]
D
D
@]
.....r-
" f7(
\ f3{
A Delivery includes a one time building placement and leveling (up to 6 inches).
8 If the customer requires the delivery driver to perform duties that make the delivery longer
than 45 minutes, the customer agrees to pay a charge of $40.00 per hour.
C The customer may incur an attempted delivery fee if the answers to questions 1-5 above
prove inaccurate and the driver is dispatched but cannot deliver the building.
D The customer must pay all deposits, fees, delivery costs, and applicable taxes before the
scheduling of Lease with option to purchase orders.
E The customer must pay a non-refundable deposit (amount to be determined by
management) on special built buildings prior to the order being processed for construction.
F Cook Portable Warehouses carry a lifetime warranty against termite damage and decay.
Therefore, it is not necessary to place them on blocks. However, at the customer's request
at the time of placing this order, the driver will block the buildings no more than 1 concrete
block high provided the customer has the blocks on hand at the time of delivery. There is a
charge of $30.00 for bUildings up to 16' and $40.00 for buildings up to 24'. Buildings
longer than 24' must be placed on level ground.
G The Lease with option to purchase program has been explained. The customer understand
that the term of the agreement is for 36 months and that 55% of each rental payments
(excluding taxes, fees and other charges) will be applied towards the purchase price if the
option to purchase is exercised.
H The customer understands that all rental payments are due on the last day of each month.
Also, if the bUilding is delivered between the 1st and the 15th of the month, the first rental
payment is due by the last day of the same month. If the building is delivered between the
16th and the last day of the month, the first rental payment is due by the last day of the
I Any permits and/or compliance of local or state regulations, as well as the anchoring of the
building, are the customer's responsibility.
J The customer releases Cook Portable Warehouses and its agents or employees from any
and all claims of damages to property (e.g. shrubbery, trees, lawn, fences, driveways,
septic tank, overhead, underground utilities, vehicles, children's toys, etc..), and any other
personal property associated with moving a portable storage building on-and-off the
K In the event that the delivery driver attempts to install the portable building and becomes
stuck, the customer agrees to pay any and all associated costs, including, but not limited to
I have read and understand the above items and have reviewed the diagram on page 1 of this order
form for correct placement of all options including door(s) and window(s).
Date ~~C; -- 0 V Print Name ---(jl;;((L
,<..(.~
Customer Signature
Date
COOK PORTABLE WAREHOUSES
RELEASE FORM - DELIVERY
As the undersigned has guaranteed. in writing, clear and unobstructed ingress and egress to the
del1very locations~ the undersigned hereby releases Cook Portable "rare houses and it's agents
oremp!oyees from any and all claims of damages to shmbbery, trees, lawn, septic tank,
overhead and underground utilities, andior other personal property associated vvith inStalling a
portable storage building on the undersigned's premises, and agrees to hold Cook Portable
\Varehouses harmless for any claim of damages by reason of such instaI.latlon.
J f the undersigned has a fence around the delivery location, or installs a fence after delivery, the
undersigned agrees to make the property accessible in the case of a default on the lease and/or
Cook Portable \Varehouses must rettieve the building. The undersigned also hereby grants
permission for Cook Portable \Varehouses to remove the fence or similar structures to gain
access to the portable storage building and, in doing so, agrees to hold Cook portable
Warehouses harmless for any claim of damages by reason of such removal.
r n addition, if, at the insistence of the undersigned, the driver attempts to install the portable
storage building and becomes stuck, the undersigned agrees to pay any and aU associated costs,
indud' ng, but not limited to;{OW truck}ees_ ,
~ ' L/o ,U/v~
~omer gnatur; U
~ ~'
'?7
river Signature
ca~. ~~ (!;J i>
Date
F-5
"
/C)~f
NATIONAL DESIGN, INSPECTION & ASSOCIATES, INC.
P.O. BOX 627
RUSSELL VILLE, ALABAMA 35653
PHONE: 256-332-4157
FAX: 256-332-2806
EMAIL: NDI@CHARTER.NET
RE: Manufacturer: Cook Portable Warehouse
Occupancy: Storage
NOI Plan #: 3R49S-002
To Whom It May Concern:
This is to certify that the plans for the referenced modular building have been
reviewed and approved as being in compliance with the 2004 Florida Codes and
Standards, with 2006 supplement, subject to the following limitations:
1. Approval covers factory-built structure only.
2. Items installed at the site are subject to review, approval, and
inspection by the local authority having jurisdiciton.
3. The Chapter 633 Plan Review and Inspection shall be
conducted by the local fire safety inspector.
4. Signed and sealed plans shall be on file with NDI, Inc.
5. Not approved for High Velocity Hurricane Zone (i.e., Broward
and Dade Counties).
Sincerely,
~}:!3V;\mf,j'rf)(3, 'SNVld
5111'H~~Hd32:K?.:\JJ8
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.E~.s. CARDWELL. ..,,- !!!l~sriona1 En.&ineu" Lan.d Su,,:!1!?!.
1000 S Reicher Roa4 .. Slag ,4,., Umt f'I: 11 ~ L.a.rgc, Flon4a '3}771 .. Phone (;'2i) 524" 1905 .. FIl)I. (721') :52'-- \:199
July 1 i, 2006
Cook Portable' Warehouse
.I 00 Douglas ST,
Va.idosta" GA 31603
TO WHOl\i IT MA. Y CONCER..t'i;
I Fred S. CardwelL PE. app,,-we: [he option of tnst~mng (1) Simpson H3 H"umc3.:)e clip or
equal (0 e:~cb nC;Of ]01".. 1.."\ heu to h2.ving (1) SlmpSO;} H3 HuITi:;ane clips or equal to every Qtner
floor .leist. As shewn (\:.1 plans
l'f you bav~ any quesrlcn" please f::e.l free to call me.
Stncerely,
\
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Fc-d S. C::u'uwell
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