HomeMy WebLinkAbout07-7359
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
't ,.-..>:. "..
t Vr t.
7359
Permit Number:
Permit Type: ACCESSORY BLDG.
Class of Work: SHED INSTALLATION
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
Address: 38735 9TH AVE
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-08100-0120
4,085.75
Name: SNYDER,STEPHEN
Address: 38735 9TH AVE
ZEPHYRHILLS, FL. 33542
Phone: 813361-9323
82.50
82.50
1/08/2008
SHED INSTALLATION
Nct- ~;dJ IA
lU~'S Sf.J uJo.h
Cfl'\Ce (lJ fr:
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REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to 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 notice of commencement."
(2a~-
CONTRACTOR SIGNATURE PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
Fee Simple Titleholder Address I
City of Zephyrhihs Permit Application
Buildinb Department
I
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Phone Contact for Permitting
}...{ Y DeJ( Owner Phone Number <? 13 - 3t::>/-7
Of ..{i, A 1/ e - Owner Phone Number I <1/'3 -.;2 t..f 5..... .%o?tl
Owner Phone Number I I
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Fax-813-780-0021
813-780-0020
Date Received
, ! ,v- L
/~ Owner's Name ~~;Z::{
/ Owner.s Address I '3 ~ ( 3.5
Fee Simple Titleholder Namel
/ JOB ADD.RESS
I
q~h A. J1&
I P~RCEL ID#I ! I ~ '- L ._~ !-<....,( \ <'. ('0 \ ( .(
I (OBTAINED FROM PROPERTY TAX NOTICE)
D NEW CONSTR D AqD/AL T D SIGN 0 MOVE D DEMOLISH
D INSTALL D R'lPAIR
PROPOSED USE D SFR D C~MM D
TYPE OF CONSTRUCTION D BLOCK D FRAME D
I
/' DESCRIPTION OF WORK I' :~n. ~\ I I ,\ . \ \. ' .\. '. I ',. I
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BUILDING SI~ II c;l., A J fp I SQ FOOTA:E I I * ~: fIf I HEIGHT I J f PI. I
"r.II'...III...III..'.'.......II..........IIIII..II........11....11..........111..........,....'.11........1111111.....111..........1'..'11........
I
VALUAflON OF TOTAL CONSTRUCTION
AMP S~RVICE D PROGRESS ENERGY
3 <3 '7 3.5
LOT #
SUBDIVISION
WORK PROPOSED
I
o
OTHER I
OTHER
STEEL
D
GAS
ROOFING
I
I
I
I VALUAf'ON OF MECHANICAL INSTALLATION
D S~ECIAL TY D OTHER
D
W.R.E.C.
BUILDING
/ 1$ if,o<:6 6, '7.5
1$
1$
1$
D
"--(
D
D
D
D
ELECTRICAL
PLUMBING
MECHANICAL
\ .. I
4. "( -~
FINISHED FLOOR ELEVATIONS
DYES
DNO
BUILDER /
SIGNATURE
/
COMPANY
REGISTERED
I~/L. POffAbI~ S~
I Y / N I FEE CURRENT I Y / N I .
License # I
COMPANY
REGISTERED
Y / N FEE CURRENT
License #
Y/N FEE CURRENT
License #
Y / N FEE CURRENT
License #
Y/N FEE CURRENT
Y/N
PLUMBER
SIGNATURE
Y/N
Address
MECHANICAL
SIGNATURE
Y/N
Address
OTHER
SIGNATURE
Y/N
I License #
I
11111I111111I11 1I11111111111111I1111111111111111111111111111111111111lillllllllllllllllllllllllllllllllllllllllllllllllll1I1I111I111I1II1111111111
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) se~ of Energy Forms; R-O-W Permit for new construction,
Minim.um ten (10) working days after submittal date. ~equired onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for ~ubdivisionsllarge projects
Attach (3) complete sets of Building Plans plus a Life safety Page; (1) set of Energy Forms. R-O-W Permit for new construction.
Minimum ten (10) working days after submittal date. ~equired onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit forJ" new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
....PROPERTY SURVEY required for all NEW constr ction.
II111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000)
.. Agent (for the contractor) or Power of Attorney (for the owner) would bel someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs Sewers Service Upgrades AlC Fehces (Plot/Survey/Footage)
I
Address
COMMERCIAL
Driveways-Not over Counter if on public roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "d~ed" restrictions"
which may be more restrictive than County regulations. The ufdersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESf,ONSIBILlTIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to be lice sed in accordance with state 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 unctjlrtain 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 !contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properly li~ensed and is not entitled to permitting privileges in Pasco
County. I
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fee~ 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, thatl such fees, as may be due, wilt 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 issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in acc6rdance 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 CO~y of the "Florida Construction Lien Law-Homeowner's
Protection Guide" prepared by the Florida Department of Agri ulture 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 installatiolil as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work iIt 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 c mpliance. Such agencies include but are not limited to:
Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
Southwest Florida Water Management Distritt-Wells, cypres.s Bayheads, Wetland Areas, Altering
Watercourses.
Army Corps of Engineers-Seawalls, Docks, Navig ble Waterways.
Department of Health & Rehabilitative Services IEnvironmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks. I
_ US Environmental Protection Agency-Asbestos a~]atement.
_ 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" wilt 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" " in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fil the area within the stem wall.
If fill material is to be used in any area, I cert fy that use of such fill wilt not adversely affect adjacent
properties. If use of filt is found to adversely affe t adjacent properties, the owner may be cited for violating
the conditions of the building permit issued unde the attached permit application, for lots less than one (1)
acre which are elevated by fill, an engineered drairage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faitl to inform the owner of the permitting conditions set forth in
this affidavit prior to commencin~ cons~r~ct!on. I understand ~hat a s.eparate perm~t may ~e requir~d for elect~ica.1 work,
plumbing, signs, wells, pools, air conditioning, gas, or other InstallatIons not speCifically Included In the application. A
permit issued shall be construed to be a license to proce?d '^lith the work a~d not as authori~y !o viol~t~, cancel, alter, or
set aside any provisions of the technical codes, nor shall Issuance of a permit prevent the BUilding OffiCial from thereafter
requiring a correction of errors in plans, construction or violatibns of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced wi hin 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 Officia~ for a eriod not t~ exceed nln~ty (,90) da~s and Will demonstrate
justifiable cause for the extension. If work ceases for ninety ( 0) consecutive days, the)ob IS conSidered abandoned.
OWNER OR AGEN
l!~it~ed an~~w~n t~ (~r ~ffir~~d! be.fore~e ~h\i~" ; .
Whp Is/are personally known to me or has/have produced
'l -;-:, ,_ as identification.
_\.~_.',~\,",~_ ~,_ ~~,' 'l>l
l ). ......'..~ Notary Public
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Notary Public
commll isslon No.
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Name of Notary typed, t
! ~..... Expires October 29, 2010
I ,.~ I I IoNIecI Trov~" ~ lftWt.nao., Ino 100-38&-7019
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commisslon..J~~'f.~, Karen L. Miller
i~~ ..f: Commission # 00609664
Name of N ~ "';'385-7019
IIcIN*l r",. ,... . ,........... Inc ovu-
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner:
/'),.... /-
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Date Received:
I_L\_('(~
Site:
3 ';~:7 ..:-.::.~ r.:=., C{-\>h t-\( -,p
Permit Type:
c~, Vl.. r \\)[; ) ;,.., C f:.,C:.-
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Approved withe below comments: fJ
~
0:1-
Denied withe below comments: 0
Approved wino comments: 0
~ If/I )~,f8qCf( ,~qll be ll1fi'
-$} 0V1Y 2 (cd 6..;, JJ~ s f) f?{ lot
I
TIlls oomment shed Sh:2ept mth the~:; ::oc Pl~a ~ ~
Kalvin itzer - Plans iner Date Contractor andlor Homeowner
(Required when comments are present)
STATE OF r-LO!~!DA
COUNTY OF PASCO
THIS IS TO CERTIFY THA T THE FOREGOING IS A
TRUE AND CORRECT coPy OF THE DOCUMENT ON FILE
OR OF PUBLIC RECORD IN rHIS.O~10i:1ITNeSS MY
HAND A,ND OffiCIAL SEAL 1.11:; DAY OF
Jan _ 2!.P2
JE~Zt~CIR~OURT
BY OEPUTY CLERK
I 111111/11/1111111111111111 1111I11I11I11II111111111111111111
2008002719
Rcpl : 1152560 Rec: 10.00
OS: 0.00 IT: 0.00
01/07 /08 ~~ _~~_ Dpty Clerk
JED PITTMAN, PASCO COUNTY CLERK
01/07/08 01: 42pm 1 of 1
OR BK 7730 PG 1961
NOTICE OF COMMENCEMENT
Permit No.
Property Identification No.
II-.~lo-.z 1- 0010- Oq id).... Ol.;(O
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.
l.Description of property (legal de~cription:) Z t-\r g, f ~ 51- Lor> 1.1... < 13 E LIC <$1
a) Street Address: ~ ~ '1 3~ l Vi:::.' (1,,'"\ it .
2.General description of improvements: a?O S' f...( e.o '01"-1 J4 hI ~ I
3.0wner Information '.....-.. p __
a) Name and address: 5 ''e.. v e. ,~ "~ G::. 6ft
. (::; b) Name and address offee simple titleholder (if other than owner) :3 % 135
c..~ q c) Interest in property
R.contractor Information f
a) Name and address: c.~ t:.. Or-r 14 bl E.
b) Telephone No.: -a13-7~'f!:'" '7~~9
5.Surety Information
a) Name and address:
b) Amount of Bond:
c) Telephone No.:
6.Lender
Cf-f::h f\v-e.. 2eph. F L 3 ~S~ 2-
S H~PS/ 3/~ I /Ac.vf ~ol 'Z€PI,YfJJJ6;r;
l. I '
Fax No. (Opt.) .t5 It 111c:Ae.- 833'-1 z...
Fax No. (Opt.)
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COOK PORTABLE WAREHOUSES ORDER FORM
GENERAL AND DEALER INFORMATION
DATE: 12/14/2007
ACCOUNT:
SALES PERSON:
VISTA MARKETING
CARL CASTEN
ZEPHRYRHILLS FLA.
DEALER PHONE #: 813-788-5459
BUSINESS NAME:
(Ut-rlLt u::,t UNLY)
DEALER FAX #: SAME
DEALER LOCATION:
)EALER NUMBER:
293801
MODEL #
CITY
USE DIAGRAM BELOW TO SHOW OPTION PLACEMENT
LOCATION OF BUILDING:
BACK
STYLE SIZE SHINGLE COLOR
BARN X DARK NEW
BROWN
ECONO X BLACK USED
WIN LOFT BARN 12 X 16 WHITE
SOLD
UTILITY X CHARCOA
LEFT DD RIGHT L GRAY
RENTED
GARAGE X LIGHT
BROWN
LOFT GAR. X GREEN XX
CABIN X
xx
xx
FRONT
EY CODE FOR OPTION PLACEMENT D= SINGLE DD= DOUBLE DOOR S= STEEL
DOOR DOOR
F= A/C
FRAMEOUT
G= GARAGE
DOOR
MISCELLANEOUS RAISE LOFT SIX INCHES. PLACE DBLE. DOORS ON RIGHT
SIDE OF BLDG. CENTERED. PLADE ONE EACH WINDOW
TOWARD RIGHT SIDE BACK AS SHOWN. THANKS!
STEPHEN PAGE OR ROBERT SNYDER
CUSTOMER NAME(S)
HOME
WORK
CELL
38735 9TH AVENUE
ADDRESS
HOME
~~Et 813-245-5628
IN LUDE AR A DE
CITY
STATE
33542 PASCO
ZIP COUNTY
HOME
WORK
CELL
ZEPHYRHILLS FL
INCLUDE AREA CODE
NAME OF EMPLOYER RETIRED
DELIVERY ADDRESS IF DIFFERENT THAN MAILING ADDRESS
SOCIAL s~~~~~ 175-26-8013
MANDAT RY N ALL RT RDER
CITY
STATE
ZIP
COU NTY
DRIVER'S LICENSE
NUMBER
DATE OF BIRTH
5536-768-32-369
10/9/1932
E..MAIL ADDRESS
PAGE 1
REVISION 5/07
SALES PRICE
$3,345.00
SALES PRICE
SECURITY DEPOSIT
DISCOUNT
DISCOUNT
SERVICE FEE
OPTIONS TOTAL
$245.00
OPTIONS TOTAL
DELIVERY FEE
SUBTOTAL
$3,590.00
SUBTOTAL
TAX ON DELIVERY
OPTIONAL DOWN
PAYMENT
TOTAL DUE FOR DELIVERY
LOCAL TAX: 7 %
$251.30
TAX ON DOWN
PAYMENT
TOTAL DUEl
]
INGLE USE TAX (TN)
MONTHLY RENT
AMOUNT
SERVICE FEES
MONTHLY STATE
SALES TAX
OPTIONS
PRICE
RAISE LOFT
$75
DELIVERY FEE
$135
MONTHLY LOCAL
SALES TAX
MONTHL yT~:~~l::::::::::::::::::::::::::::::::-:::::::::]
2 EA. WIN. 24X36
170
TAX ON DELIVERY
$9.45
TOTAL DUEU4,085. 75
OPTIONS TOTAL
$245.00
AMOUNT RECEIVED BY
DEALER
$1,000.00
CHECK NUMBER OR
REFERENCE NUMBER
3148
COD AMOUNT 3 085.75
HWY 301 NORTHTO 9TH AVENUE. TURN RIGHT.
FOR DELIVERY STATUS, LOG ON TO COOKPORTABLEWAREHOUSES.COM
HOW TO LOAD THE DOORS?
TOWARDS THE CAB XX
BACK OF THE TRAILER
DRIVERS SIDE
PASSENGERS SIDE
ALL WEATHER DEUVERY?
YES HARD SURFACE XX
NO SOFT GROUND
FOR CUSTOMER
IPLEASE PRINT)
PAGE 2
REVISION 5107
These questions mU,st be answered for all orders!
1 Is there clear access to the desired delivery location?
(i.e. is the area clear of trees, overhead wires, ditches, etc.)
2 Will driver need to cross property other than your own?
If Yes, please call the office if this is a Rent-To-Own order.
3 Do you own the property where the building will be placed?
(If not, do you have owner's permission to place building
on the property?)**
\ (;iIS
\
~
~~~
** A signed document from the property owner granting Cook portable Warehouses 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 ~ .
** Unless there is a gate wide enough to accommodate our truck a~ler as well. s the
width of the building, the order cannot be placed on a Rent-To-Own basis.
4a How wide is the gate opening? I
Yes
No
[ill
D
o
I XX I
A Delivery includes a one time building placement and leveling (up to 6 inches).
B 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 Additional charges are payable up front and must be approved on site by phoning the main
D The customer may forfeit all monies paid if the answers to questions 1-4 above prove
inaccurate and the building cannot be delivered--:-'
E The customer must pay. all deposits, fees, delivery costs, and applicable taxes before the
scheduling of Rent-To-Own orders.
F The customer must pay a deposit (amount to be determined by management) on special built
buildings prior to th~ order being processed for construction. .
G Cook Portable Warehouses carry a lifetime warranty against termite damage and decay only.
Therefore, it is not necessary to place them on blocks. However, at the customer's request
and approved on site by calling the main office, the driver will block the buildings no more than
1 concrete block high, provided th~ customer has the blocks on hand at the time of delivery for
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.
H In the event legal proceedings are filed to enforce your obligation to pay for the building
described herein, you agree to pay Cook Portable Warehouses its reasonable attorney's fees
and cost of suit, in addition to any and all other sums due.
I The Rent- To-Own 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.
J Any permits and/or compliance of local or state regulations as well as the anchoring of the
building are the customer's responSibility.
K The customer agrees to give the delivery driver a clear and unobstructed ingress and egress to
the delivery location.
L 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 customer's
M 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 the reverse side of this
order form for corr~ct f'acement of all options including door(s) and window(s).
::: ;:~:; cu~ome::~::::;I?~~.~~N'
PAGE 3
REVISION 5/07
COOK PORTABLE WAREHOUSES
PERMISSION OF DELIVERY
As the undersigned has guaranteed, in writing, clear and unobstructed ingress and agrees to the
delivery location, the undersigned hereby releases Cook Sales, Inc. and its agents or employees
from any and all claims of damages to shrubbery, trees, lawn, septic tank, overhead and
underground utilities, and or other personal property associated with installing a portable storage
building on the undersigned's premises and agrees to hold Cook Sales, Inc. harmless for any
claim of damages by reason of such installation.
In 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 all associated costs,
including but not limited to tow truck fees.
Upon delivery all Cook buildings are leveled by the driver. I understand the site where the
building is to be placed must be prepared and ready for the building at the time of delivery, as
per question B on the order form. This could possibly result in an additional charge. The
building could become un-level due to the door to be hard to open. Cook will be glad to tell you
how to re-Ievel the building. If Cook comes to re-Ievel the building it could result in a re-
leveling fee. Installing building on cement blocks is an extra cost.
I understand that it is against Cook policy to put a building being bought on Rent-To-Own
behind a fenced in area unless there is a gate wide enough without taking part of the fence down
to get truck and trailer inside. The building must be accessible at all times.
I understand if for any reason the Cook building should be picked up that I must make it
accessible and if for any reason the building needs to be moved-it must be moved by Cook.
I also acknowledge and understand that the obtaining and completion of any permits and or
compliance of local or state regulations as well as the anchoring of the building are my
responsibility.
S
~o7
CU TDATE
Q
SIGNATURE OF WITNESS
'COOK PORTABLE WAREHOUSES ORDER FORM
DATE:
BUSINESS NAME:
VISTA MARKETING
DEALER PHONE #: 813-788-5459
ACCOUNT:
SALES PERSON:
CARL CASTEN
DEALER FAX #: SAME
lUt-tlCt: u~t. UNLY}
USE DIAGRAM BELOW TO SHOW OPTION PLACEMENT
BACK
STYLE
BARN
SIZE
X
SHINGLE COLOR
DARK
BROWN
NEW
LEFT
ECONO
X
BLACK
USED
LOFT BARN /,;2." XJk:,
WHITE
SOLD
X
CHARCOA
L GRAY
LIGHT
BROWN
GREEN
RENTED
RIGHT
UTILITY
X
GARAGE
X
LOFT GAR.
CABIN X
FRONT
EY CODE FOR OPTION PLACEMENTD SINGLE DD= DOUBLE DOOR S- STEEL
DOOR DOOR
F= A/C
FRAMEOUT
G= GARAGE
DOOR
MISCELLANEOUS
~ef1/1Il O~ Rofk/'~5NyDef(
~USTOMER N ME(S) e.J Q
:3':? 7,~.~ q-t~ Ave ' -
Zef1hVY'}lflIS'jfi. ~~~
CITY STATE' ZIP COUNTY
NAME OF EMPLOYER
CITY
STATE
ZIP
COUNTY
SOCIALS~~~~ 17~-~- rg(f)L
MANDAT RY N ALL RT OR ER
DRIVER'S ~I~~~~~ 5 ~ ~7 b8';.-5:<'-'~
DELIVERY ADDRESS IF DIFFERENT THAN MAILING ADDRESS
DATE OF BIRTH
/0-
E..MAIL ADDRESS
PAGE 1
REVISION 5/07
nC/l:ijplli<tE1
~ . /I/'~
SALES PRICE ~~~
...----
DISCOUNT
h~
OPTIONS TOTAL .
.If? :~
SUBTOTAL 3';;5?~
-----
co'"'"", ,%1; :3-f!:-JCJ
INGLE USE TAX (TN)
SERVICE FEES
4t I'~C~
DELIVERY FEE '..::J 7 ,.
TAX ON DELIVER#' 9'> '/5-.
TOTAL DUE~t137" el
SALES PRIC;\t- '3%.-
SECURITY DEPOSIT
----.
DiSCOUNT
'*'- 'J ,.J/ .d2-
OPTIONS TOTAL A 77"
rz~
SUBTOTA~35 0" ~
SERVICE FEE
DELIVERY FEE
TAX ON DELIVERY
OPTIONAL DOWN
PAYMENT
TOTAL DUE FOR DELIVERY
TOTAL DUEl
TAX ON DOWN
PAYMENT
MONTHLY RENT
AMOUNT
MONTHLY STATE
SALES TAX
OPTIONS
PRICE
MONTHLY LOCAL
SALES TAX
_n_______~_n____ ____________~___________.,
TOTAL!
MONTHLY RENTL..................................,............................,..............J
COD AMOUNT
FOR DELIVERY STATUS, LOG ON TO COOKPORTABLEWAREHOUSES.COM
HOW TO LOAD THE DOORS?
TOWARDS THE CAB XX
BACK OF THE TRAILER
DRIVERS SIDE
PASSENGERS SIDE
FOR CUSTOMER
ALL WEATHER DELIVERY?
YES HARD SURFACE XX
NO SOFT GROUND
(PLEASE PRINT)
PAGE 2
REVISION 5/07
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NATIONAL DESIGN, INSPECTION & ASSOCIATES, INC.
P.o, BOX 621
RUSSELL.\/ILLE, ALABAMA 35653
PHONE: 256.332....151'
FAX: 256.332.2806
EMAIL: NOI@CHARTER.NET
RE: Manvr.aurw: Cook PortaWe W.nthoUM
QcCUpllncy: ~
NO' Plan #: 3R4M-002
To Whom It May Concern:
This is to certify that ttMt plana for the referenced modular bUilding have been
reviewed and approved .. being In compliance with the 2004 FIorict. Codes and
S.ndards, with 2008 8upplement. subject to the following timitationa:
1. Approva' eovera factDry-bu11t structure only.
2. I18me installed at the .Ita aN .ubJect to review, approval, and
ina~n by the IOCIII authority Mvlng juriedici'llon.
3. The ~r 833 Plan Review anclln.pectlon shall be
conducted by the local flnt ..fBty inapector.
4. Signed and _led plane shill I be on file with NOlt Inc.
5. Not approved for High Velocity Hurricane Zone (I..., Broward
and Dade Countl_).
S;ncef'ely,
National Deaign. Inspection'" Associ...., tnc.
RE\!!~\~ ~ATE 7'1-0 r
OF.;;::EPHYRHILLS -
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FBf.D S. CARDWELL Pro isslonal En ineu" Land SI.lr'I'~'Of"
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1000 S Beicr-,er Roao . Bldg r\, U:m t; ~ 1 ~ LArgo. FloniU> '33771 .. Phci1t: (i'27) ::24~ 1905 .. Fp. (72'7) :52"~;:199
July l i. 2()(}6
Cook PQnabl~ Warehouse
100 Douglas ST.
Va.ldosta. GA 316()3
TO WHOr'ii IT M..'\. Y COl'';CER.''''i;
I Fred S. Car:;iwelL PE, appr~)Ve the option of lnsrclling (1) Si.mpson H3 Humca:Je clip or
eqU:=.i to eacb noor JOIn. in heu to t,;?,ving (2) SlmpSO'l !'-13 Hl,lm;;:ane cllps or equal to every other
floor joist.. As shewn ('0 plans
if you havl:. any guestlon::. pleas;; feel frtOe to call me.
5tncerely,
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State: ~)f FlorIda
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