The URL can be used to link to this page

Home My WebLink About13-13991 , CITY OF ZEPHYRHILLS 5335-8TH STREET � " , � �sis)�so-oo20 1399 MOBILE HOME SET-UP Permit Number: 13991 Address: 7925 KAY MARIE AVE LOT 355 Permit Type: MOBILE HOME ZEPHYRHILLS, FL. Class of Work: MOBILE HOME SET-UP Township: Range: Book: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Square Feet: Subdivision: GRAND HORIZONS Est. Value: Parcel Number: 34-25-21-0180-00000-3550 Improv. Cost: 8,500.00 Date Issued: 4/01/2013 Name: LEONE KEN & CHERYL Total Fees: 7,158.98 Address: 1433 TIGER LILY LANE Amount Paid: 7,158.98 JOLIET IL 60435 Date Paid: 4/01/2013 Phone: (815)729-3015 Work Desc: NEW MANUFACTURE HOME SET UP 1799 SQ FT L . 1, 5. DOLPHIN AIR SYSTEMS MOBILE HOME SET-UP 60.00 WATER CONNECTION MOBILE HC 320.50 HI TECH CONSTRUCTION SERVICES IN MOBILE HOME MECHANICAL 40.00 MOBILE HOME PLUMBING 40.00 HI TECH CONSTRUCTION SERVICES IN TRAFFIC IMPACT FEE 99% 3,595.68 TRAFFIC IMPACT FEE 1% 36.32 WATER METER RES 3/4" 314.20 IRRIGATION CONNECTION 266.00 IRRIGATION METER 314.20 POLICE IMPACT FEE 254.00 FIRE IMPACT FEE �, 273.00 PUBLIC SAFETY 5% 26.35 PARK FEES MH �� 57 C✓ , (� � ^ _�3 � �/eV'I'ti C�1��1n �G�`�-�—� N�.� F��s�� R.��'cc .e�d �16-�3 � �t�� (� � �nn�.� MOBILE HOME ELECTRIC - ��3 � / 77� /3G� MOBILE HOME A/C �J� ''7 Z r_ ?..��5 MOBILE HOME U I �-l �J FINAL�_�U�1� REINSPECTlON FEES: Reinspection fees will comply with Florida Statute 553.80(2)(c)when extra inspection trips are necessary due to any one of the following reasons: a) wrong address b)condemned work resulting from faulty construction c) repairs or corrections not made when inspection 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 Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances .% .: � � CONTRACTORS SIGNATURE PERMIT OFFI PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER �: P�4SC0 COUNTY, FLORIDA • ° Permit No. �`1 � Date Permitted -/-/3 Builder Name/Owner Name !�j 1�(�� >h s�n`��n�`� Control# County Parcel No. .3`�l S-Z/_ �/c�IC-C��LC�- -3�� SubDiv: �u(C ✓Z<�'► Address/Location 7G ZS /c l c"� ✓�� '/"'�� 3`5� Classificalion/Type of Use /llt'[t) /YI�h�� /�rY►�`� — . � TRANSPORTATION IMPACT FEE � Rate: Sq Ft Unit: 1�/ - Exempt [] Yes � No HoW Determined Impact Fee Amount $ 3��3�°�D_ Zone No. TAZ: SCHOOL IMPACT FEE Account (D56) Single-Family Detached House Amount $ /��[�` (057) Mobile Home (058) Other Residential 123) Collaction Fee Exempt Yes � No How Determ(ned PARKS AND RECREATION FEE Land Account Land Credit Land Total Recreation Account Recreation Credit Recreatlon Total Zone TOTAL AMOUNT $ � �]�. �3 Exempt � Yes � No How Determined LIBRARY FEE Land Account Land Credit Land Total Facility Account Faciljty Credit Facility Total Exempt � Yes ❑ No How Determined Total Amount �� RESOURCE FEE ERU � TOTAL AMOUNT Prepared By /' � ai Checked Sy _ � i NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE BEEN PAID AND RECEIPTED FOR BY A CENTRAL PBRMITTING OFFICE OF PASCO COUNTY Acknowledgemen►below does not lmply accepfance of concurrenoe,but simply receipl of a copy of this form,placing the building permit owner on notice of this assessmenl and tha condllions af payment for same. QATE R�CEIVEp BY RECEIPT NO DATE gy 613-78p-0020 City of Zephyrhills Permit Application Fax•813-780-0021 Building Department Date Received 3-I3- 3 Phone Contact for Permitting �� -- ' `.J�� r � �� r� r i ��r i� t� Owner's Name �' ' wner Phone Number IO�ei`~.J ��S 1 � ��e,�" �.L�435 � Ownels Address � J �- Lt l � Ow�er Phone Number Fee Simple Titleholder Name Owner Phone Number � Fee Simple Titleholder Address �G M� � JOB ADDRESS N� �lre ��J� • LOT# [� SUBDIVISION �C'Jl� �Z4� PARCEL ID# � (OBTAINED FROM PROPERTV TA7(NOTICE) WORK PROPOSED e NEW CONSTR B ADDfALT � SIGN 0 Q DEMOLISH INSTALL REPAIR PROPOSED USE Q SFR � COMM � OTHER � TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL � �—� DESCRIPTION OF WORK 1 1`/w M�/� L-t'TC7� C��I�CC hDMC � BUILDING SIZE l �` U O SQ FOOTAGE� HEIGHT � /� �T^�l�rrfTRT'TlTTrr!"1�lTRTl9"'PrrrrrrTT/�R�!"I�TlTTTRTTTR•!7TlTT � l/}/ � � V� �BUILDING $�Jc�OD VALUATION OF TOTAL CONSTRUCTION � pJ �E�ECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY � W.R.E.C. �PLUMBING $ �L�� , .yZ}s '/ -� OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION i��G /��" / lJ Qp7� �� OGAS � ROOFING � SPECIALTY � OTHER �� V`��,��'_� FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �VES NO (il) V� ....�.......�...� ..�............. ...�.........;:.�.,....� .....v/ _ �� BUILDER �/ COMPANY � "" �.�� C7�5`.�k�� 'y�l SIGNATURE �L REGISTERED Y/ N F�EE�CURREI. Y J N Address L�n�se# (�,/pl J�� EIECTRICIAN ' COMPANY �� `�,F..��<<n, \� 1 �'G�'Q{� �l SIGNATURE REGISTERED Y! FEE CURREI. Y/N Address " License# �� `J�0 � a\F.� I PLUMBER �/�' COMPANY � —��+C.� C��11C"�I SIGNATURE �� REGISTERED Y/ N FEE CURRE� Y/N Address License# J�'� `�0..�13�� MECHANICAL COMPANY dIO�)N 1 y� S NStV V\�� ✓ SIGNATURE � REGISTERED Y J FEE CURRE� Y/N Address License# G'�� l OTHER COMPANY SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N Address License# �� ! 1 1 1 [ 1 1 1 [ 1 1 1 1 1 1 E 1 t I 1 1 1 1 f 1 f 1 1 1 1 1 1 f 1 1 1 i i 1 1 1 [ 1 t 1 E 1 [ 1 [ 1 E ! 1 1 1 [ 1 f 1 [1 I 1 f f I 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 submittai date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects COMMERCIAL Attach(3)complete sets of Bwlding Plans plus a L�fe Safery Page;(1)set of Energy Forms.R-O-W Permi[for new construction. Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Sitt Fence installed, Sanitary Facilities 8 1 dumpster Site Work Permit for all new pro�ects.All commercial requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Plans. ""PROPERTY SURVEY required for all NEW construction. �...^.3�4i�f..L�f..F-4F#i-�4�F�i-�F�4��C�PrF�0.�4�`�F�wF4�f��0.�S��-��i��'.-�.�� Diredions: Fill out applicaGon completely. Owner&Contractor sign back of application,notanzed If over 52500,a Notice of Commencement is required. (AIC upgrades over 57500) " Agent(for the contrector)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) 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 undersigned assumes responsibility for compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work,they may be required to be licensed 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 uncertain 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 licensed and is not entitled to permitting privileges in Pasco County TRANSPORTATION IMPACT/UTILITIES IMPACT ANO RESOURCE 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, as specified in Pasco County Ordinance number 89-07 and 90-07, as amended. The undersigned also understands, that such fees, as may be due,will be identified at the time of permitting. It is further understood that Transportation Impact 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 WaterlSewer Impact fees are due,they must be paid prior to permit issuance in accordance 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 Agriculture and Consumer Affairs. If the applicant is someone other than the"owner", I certify that I have obtained a copy of the 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 the 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 installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other govemment agencies may apply to the intended work, and that it is my responsibiliry to identify what actions I must take to be in compliance. 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 District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalis,Docks,Navigable Waterways. - Department of Health & Rehabilitative ServiceslEnvironmental Health Unit-Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency-Asbestos abatement. - 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 expressly permitted. - If the fill material is to be used in Flood Zone "A", it is understood that a drainage ptan 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 materiai is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction,I certify that fill will be used only to fill 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 affect 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 drainage 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 that a separate permit may be required for electrical work, plumbing, signs, wetls, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shail be construed to be a license to proceed with the work and not as authority to violate,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 violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six(6)months after the time the work is commenced. An extension may be requested, in writing,from the Building O�cial for a period not to exceed ninety(90)days and will demonstrate justifiable cause for the extension. If work ceases for ninety(90)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 PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDE R AN ATTORNEY BEFORE RECORDING YOUR NOTIC OF COMMENCEMENT. FLORIDA JURAT(F.S.117. ) n OWNER OR AGENT L��,L��-- CONTRACTOR � ---- --------- ---- -- �Subscrib�d and s�n (or aff�ed)b fore me this ubscrib and swom to(o i e )�be��fcy�.e-m �a� bY- -LAL�- -��---------- �/�-�--bY--��+- ��J— Who is/are personally known to me or has/have produced Who islare personally known to me or has/have produced as identification. as identification. ----- �-Gt�----- 0� --{�—`��=`=��a��Z!^!"—I�__ryo�ry Public � --��'!'1_�""'='�=- ----Notary Public Commission Na _ __ Commission Na_ _____ _ -------------------------------- ------------------------------------ Nam Name of Notary typed,printed or stamped �.�au� �.wre.m. �Yrc.rs� PATRICIA STEWART REW �,Y!'•••. PATRICIA STEWART r V ` :. ' Commission#EE OQ4�?r-; ';• � �r �, �: Expires September�; �t; =� � :� �:` Commission#EE 00�!' � ��P�;;e;� BondedThn�TroyFainlnaurance8pp-:�13: � ��, �;��'a: ExpiresSeptember; � „� '�'�„pF rk°,P' Bonded Thn�Troy Fan Insurance N�u iG',i�!' Pasco County Parcel: 34-25-21-0180-00000-3550 001 Page 1 of 1 Data Current as Of: Weekly Archive - Thursday, March 21, 2013 � Parcel iD 34-25-21-0180-00000-3550 (Card: 001 of 001) Classification 00 - Vacant Residential Mailing Address Property Value LEONE KENNETH A & CHERYL A Ag Land �o 1433 TIGER LILY LN Land �23,5�z JOLIET IL 60435-3986 Building �o Physical Address Extra Features $� 7925 KAY MARIE AVE ZEPHYRHILLS FL 33541-7719 7ust Value $23,572 Leaal Description (First 4 Lines) ASSeSS@CI (Non-School Amendment 1) $23,572 See Plat for this Subdivision GRAND HORIZONS - PHASE FOUR Taxable Value �23,572 PB 61 PG 023 LOT 355 OR 8835 PG 3690 Land Detail (Card: 001 of 001) Line Use Description Zoning Units Type Price Condition Value � 0200 MSUBM OOM1 6,000.00 SF $3.75 1.00 $22,500 � 0200 MSUBM OOM1 1,949.00 SF $0.55 1.00 $1,072 Additional Land Information Acres 0.18 Tax Area 30ZH FEMA a Residential Code GDHZLPI Code Building Information (Card: 001 of 001) Unimproved Parcel 00 - Unimproved Extra Features (Card: 001 of 001) � Line � Description Year Units � Value No Extra Features Sales History Previous Owner GRAND HORIZON HOMES LLC Month/Year Book/Page I Type C de Condition Amount 02/2013 8835 / 3690 �W Deedty 01 Vacant $30,000 03/2007 7446 / 1045 Warranty� Vacant Multi-Parcel Sale Deed 12/1995 3508 / 0207�Warranty� Vacant Multi-Parcel Sale Deed http://appraiser.pascogov.com/search/parcel.aspx?sec=34&twn=25&rng=21&sbb=0180&b... 3/21/2013 NOTICE OF CO�NCE�Nx IIIIIIIIIIlIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII � � , Permit No. Tax Folio No.3a•,S-a I-DI5J0�Dor�ov-3SSo �� TI-�'.UNDERSIGNED hereby gives nodce that improvemcnu will be made to certain rcal properry,and in accordance with Section 713.13 of the Florida StaNtes,the following inforsnation is provided in this NOTICE OF COMMENCEM�NT. (9�na�nl� \}or iur+5 Ldts�3 SS n +1 1.Description of property(lega!description): 1 1��S �� `' �L�• —_ � r�� v 4S a)SVeet(%ob)Address: 2.Gcneral description of improvemenu: �1 ..��n er� t�c�� rnc�r�u c�c.- w�� 3.Owner Info tion Ia)Name and address: I{e�c.YN l.ro+.ey�4 3�'f nar 1.�I I..�1 N��ee.r IL Go 4.�i b)Name and address of fee simple titleholder(if othe than owner) _ c)Interest in ptoperry . 4.ContractorInformation �� , (� P 5S� C�M,��`� (�l��, ��. �� I a)Name and address: 4� °`' b)TelephoneNo.: `� FazNo.(Opt.) '1 �-K�a `33g��o 5.5urety Information � � a)Name and address: � b)Amount of Bond: �. ° ' c)Telephone No.: Fax No.(Opt.)� 6.Lender • � a)Name and address: . Fhone No. 7 Identity of pecson within the State ofFiorida dssignated by owner upon whom notices or other documcnts may be served: a)Name and address: b)Telephone No.. Fax No.(C)pt.) 8.In addition to himsclf,owaer designates the fotlowing persen to rer,eivc a copy of the L.ienor's Notice as provided in Section 713.13(1)(b),Florida StaNtes: . a)Name and address: , b)Telephone No.; Fax No.(Upt.)_ �,, 9.Expirauon date ofNotice of Commencement(the espiraUOn date is une year from the date of recording unless a different date is spccified): _ WARNING TO OWlYER: A1VY PAYM�NTS�14AD�BY THE OWN°R A:TER 1°FTE EXPIRATION OF THE NOTICE OF COMMF.NCEMENT ARE CONSTDERED IMPROPER PAYMENTS tJNllEIi CH�.PTi'sR 713,PART I,SECI'ION 713.13, I� RLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWlCE FOF IMPROVFMENTS TO 1 OUR PROPER'TY. I A NOTICE OF COMMEA'CEMENT MUST BE RECORD�D AND POSTED OtV 1'FIL�JOB SITE BERORF.THE FIRST i 1NSPECTTON. iR YOU INT�ND TO OBTAIN I'INANCIA'G,CONSUL'C YOUR LlNDL'R OR AN ATTORNGY B�F�RE CuYiIYIElVCING�VGRIti OR Ii�i.GRDi�G YGUR N01'iCr.G COiviM�ivui;litii�'i. J`� � . * * S'CATE OF FLORIDA � �G � � � IQ. � ' Sign curo u r or Owncr's A�thori Offipu/ rec�artn5flManager � / , � ,�� , «7t —i r� ' PrintNamo � H�\. ^ • �j„ i � The foregoing instrumeni was acknowledged befo:e me this�ay of�"_�20�by ��*� � " � � � ��-�� ` _ � �.r �r,yu y�.��Y _ _�(r�pe of authority,a,g.officer,trustee, 0� • x ,A ' ,; ' attorney in fact)for�� L��namc of party oi�b• atf cf rrhom instrument was executcd). �� , / l�C�' • �/ � Personxtly Iv�own,OR Produced Identification v Notary Sigr.acure__ i �� s # � ' Type of Identification Produced��-��Gn'� �-�� Nama(nrint)� �•I�� OR �u Y Verification pursuant to Sectien 52.525,Florida Statutes.Under per,alties of per;Lry,?declsre that I have rcad the fore;oiag and tha: `L z U � w the facu stated in it are true to the best of my knowledge and beli ' � w LL- c� U V � �� aJ � r•oxMSrnoc.n�exaio � , N z CJ 11) _I � � ^ ��y%�r"ty�; PATRICIA STEWART RcVJ g��amre ci aeua:Perso. Sigmr.g m ine N . bmc a �� S `� N � W Commission fF EE 004116 � �` ��' Exp:r�September 5,2014 � W � z� �.. O �"'!R:,,;'�' eadmnwT�Faoi,...rceeoo-aes7ois w ti•. ' Ropl:iS05094 Rec: 10.00 � � � p aC O CS: 0.�0 IT: 0.00 r � LL � U U ''�; N?/IS/13 E. Mung�la, Dpty Clerk Z = O O ty �o�S � F— >- V C�Y 'qULR 5 0'NEIL�Ph D FQS�� -EHK & COMPTROLLcR U Q Q� W �3;f8/13 2:03 m 1 oF 1�}q z U U Z J OR Bh �� P� 2 / i6 Q � 1-- —� `t U [] rUm � u- � � � aQ � w . oUao} o0 � � � ozou� cn w � � � �QLL J F-^ } � H � � �i d m ' � �� ,, . �`I R,�. t� '�c�� w City of Zephyrhills BUILDING PLAN REVIEW COMMENTS ,j� / /� Contractor/Homeowner: (7`r,� ��G. ( �Y� �i'�C�1�"1 Date Received: 3� ( -3� ��-� Site: �� r� ,�Cl Cf /�/'�'P_ ,�'7� Permit T e: � 7gJ S ��' /�t°Gl� /Y�C�iG�ac�7`�� '`'�'e yr Approved w/no comments. Approved w/the below comments: � Denied w/the below comments: ❑ This comment sheet shal .be kept with the permit and/or plans. �"T�/� Kalvin itzer— s Examiner Date Contractor and/or Homeowner (Required when comments are present) March 12, 2013 To whom it may concern: I Carl A Bryan give permission to Diane Beebe to pull any permits necessary to place a mew manufactured home on 7925 Kay Marie Ave Zephyrhills, Florida. �� Si ned �� Date � -��- ' �� g Carl A Bryan �f{l(,� �� G� N ota ry G�.� ;�;:�:��: PATRICIA STEWART REW :.: .- Commission#EE 004116 My commission expires =; �; ExpiresSeptember5,2014 �%h�„pF a;,•`' Bonded Thn�Troy Fan Insurance 800-385-7019 Date �✓�a'�/ . � � � `� � � 3 � - � . � � � � � V .4,(r 't " N ,�-- •'�-f-�. , . _�� ' �3 -�`�- '� � `�`t_��n,#; , �- ' � C x f°":r;` I � L�. •�'— �� - O� � \ ,,� � � � � Yt}a �� _ h '�, � e� �o � ` �� , ��=; � � , � � � � � � o � � � 4 � ,� � `�� 3 b a� � � ,� � � � Z Z � i 'L �'b ° , aa ,� �� rs � �, � '� .,, �St � � �\ � � 3 � L� 3 . � �� . � v � � , � : 3 � `- a• � v�.. � ;,°� �V. L, W � -, �'t� � 2 � 4� t�i � Q c� y� � V , �. � �R . �. � s � v a �,n : � � a �, v � � � � � � ` � � � � � � � � -� � .�_ ��y� � U � � � � w � � r a � � � � �� J � . �'Lo�f�- �- �i�,�•� �.� X 5�, � v 0 �... - � � �# � � � � � �� I�CJ �_F�.�:! �� f�1 – ��;�; –� — �_ � � � ,� � � � � � , � � � t. .��t ' "°^r . � ..... + i -> � •+ - 'cv' �b a� O i � �! �U'�� a� �I/�'�`�J �Z2� � � ,�'� �-� `� �'�. 7 5 'a �� 1� c��._ `r-� /.5`�� P� � .�'�� °��;'�" ,. -�.� e r�t�`7"�`"t.. ��.� ��-�� >C� x/�� S�""7��_ /�� .� �� t �-s s�� `�� o l � �o��o �s,,�� o�. � ��~� r�-~��1 �/-- d�..�-c�. SS/S��-vI N�� cJ.s'i N � .�''��a�-�r /�:��'�?�J�/�-E� ��J Ly �l.�o !�� c �1�rtS - ��g '�� s t `�'";' ��]�� /� ��G P �.-��`��tJ��' / l��'�'''"""_'" �� " � �� . ' I �� '��l � Q �L- , � Z „ � � <<�,,,—�, l b �-�vC'�`f''� � � � � � s � � •� �� , �, �'�.�r�:��.�.�� '�i��;►�5 � � � � � � � � �� , �� , " F u�' � �� +' � N •� � � � � x � a '�I; Jx� ^ �, o �' �• ;, d � � � �� o F r N X► a° � [ ... � +�' d � ! � � C1. r f�� l � Y � ' I , ` � r- ; � s� � � v � � �. � � �. x . � �� ... , $' � f ��7Wt �- - _ • � �� , �_... I ' . '"'� . i 4 z . ,� i R � �a ' � �� .4 � �� ° �� ;� o � � '' � � r,__ � �r� � � — ��C� �� n 40 � . �_ „ �� rJ Y�� . ' • ' x ,��o . ��: � � � �� . �� • J � � � , . �y i1 . . • . � ,� � � �{ O� �! y � •.�~ I � . �A , � � � T �L � :, : � � � � _ _ . -� . ; , • ��w►� ;, 4 � � i _�. �� r�,�d � I � ..._ � A -�I i+ � . � +#yG � i�z � _=a=41`' I � ; , ° t � � �s � ;� '�` �� ii ' I � { a�j„ 1 � �!1 ' : ' i ;, � f ��►f� r._._� A � I; � . T �Y � �`( 4�1 � I71 !�� —�$�� II 'll {� j f Q j 1i� , �� J � � i � R r � - • t r C� v �i �1 1� j 1f �ep. J►� � � j� � � ; � � k o Y � � � �_ �1 �- � - � f o �� o ; . � '� , p � I r � N •+ . � ,.�.....,..___ � 900/900d �d«�GO e�oa a� a�� 610i-9bl-Zlt�xad �s�us�ur � XX)OOCX)OCX)000000000C X)OC Penetrometer and Torque Probe Test Results (These sections below to be used when applicable. When either is used must be initialled) �ocx�ocx�ooc�oocx�000000000000000000000c �oocx�000000000000c�ocx�ooc x�oc Pocket Penetrometer Test (required if declaring soil bearing pressure greater than 1,000 p.s.f.) X�� X /�� X f,5� Testing method 1. Test the perimeter of the proposed home site at 6 locations as shown. 2. Take the reading at the depth of the pier pad or footer. 3. Using 500 psf increments, use the lowest reading and round down to that increment. X� . X /,� • X 15`Dq The result of the penetrometer test is� p.s.f. �000c�00000c �0000nc �oocx�0000000000cx ' Toraue Probe Test (required if using anchors less than 5 feet) The result of the torque probe test is �-OV inch pounds. If the test results show 275 inch pounds or less, 5 foot anchors must be used. �� (initial) A state-approved lateral arm system is being used and 4 ft anchors are allowed at the sidewall locations. I understand that 5 ft anchors are required at all centerline tie points where the torque test result is 275 inch pounds or less and where the mobile home manufacturer requires anchors with a minimum 4,000 Ib holding capacity. �oc�oocxx�oc �000000000c �000000c I declare that I have personally performed the test(s) contained erein and that the reported results are true and accurate. Date tested _ 3�rat—�3 (initial) � � i.l 4V�.�:�� . , • .. � �; JnCOJ:+�i•l ' r; O:i01l00 , .r7 PAFAPuETGRS: . ' Ut�117 Y'lIOT:: (pcC .''.lOC4`li�Ll UN17 +`r1ATlaVG LIAIL' CALL SI'L[ ° cnoCulc) I OVHG S1D::4'f��Ll YG�l'C hfGhtT.(r,clr) S7UO SPCG, 10 Widc � 120 in G in �6 in � n/a 5G in � 12 Widc i•:�in G in JG in n/� 1G In� i•S Widc - 160 in G in �JG in rJa 1 G in 1G Widc 78•S in G in JG i� ni� 1G•in , , i.OAD COiV�I710{�S: ,�_�..._... ... � _......._.._._...._._ ---� . ' M FOOf� LL « I I;ocF UL I fLOOt:LL � 1-�UOt:UL � 1•`lALL UL 1•u�r�t��L� ' 20 p'f •SG ps( j ti0 Ps( � 8 p�f � 3S Pif 2 P�f l ' ^ • _ �� DC-.YCEttkl,\G ll�\L 1.OAOS A7 CNAJJIS F��\D�11n71�`!G LI��IE:(G�.i�,Vli Y LOA05) , f'ic�;Ft�l•�Ici�l�l: Pi,:r Foolin� Conc,PC'r •.Hci��1 1��id;1�Sq.Dim Squarc Dim 7hicYn��s i30 '. '%�in Oin .'.O.Oin 4in ► To;al1•`/c;lil= 3611b� ;`l cha�sis_((Unil \^lidlhl2�rOvcrhan�)'(,tioo( Ll*Roo( Otj+(Ur,:;_r�;��J3)'(�looc ll*'rloor DL•�•Ch�ssi_DL)}i•1^lal:_Dl (�?Opcnin�s� Y`!mI�_linc-(U�t Y•lidll•J2)'(Roof L�*Roo!_DL) ��i<<i�rr:�i� �� ,;� . ��p .� �, $j/��,� �;�� C��ll Sl'LE �v! ch�:si� 4�/ r.�;�,li,�c ��``�,.•`�-��l.,'F ';., 'i 0 Wid� � �;,0.0 plf 300.0 pl( •`� ::.C% i`c'`� �� r ' :�(" I�lO. p. 12�Nidc ' � 570.0 nif 3G0.0 plf "' 1��Widc � 5�3�;:if •:G0.0 P�( ��'O•'^.+'��'^• � _ ' , ••i J 7� 1G Widc GoJ�plf ,::0.0 p:f ' �� '� : - . ^:• �1%`..� �J�° �C l�OOTL\C.°.P��C1PlG BASEO ON VF�RYI:�:G.SO;L CA?r',C1'Cl��. �'r^:'�� '-,,��•''��`Ol�;.:•,��'_ Pic�Cap�cily= (Soil C::;.ac:;�)'.(?icr r.rca) . � , S, •. .. � . �l�iCf 5p�cir�=(Yi:r C�p�ci�/-°�c:�rV��.) _ '��s��r�f1�. �'��`�ti (1�'! Ch,:��s I��«f��int�»>��1 �j !/ /. � i:% ci'ins�is PIrR �P,1C1�'G� , �J ~ �� f'lCR SI'LC� . .�"r��.t:" IVhLCN i TO f�17 3liG"X 2:i 3/1G"E'l�°Sl'L� � �� ' ��(H ] 7.00n � . �QIL OL�F�FI�\G Cy;Pi�C17Y U,\1T1�'lI0Th1 i000 ASF l i500 PS� :u40 PSF 2�00 PSF Jo00 PSf= �50�NSf- ;, 10 4`liJc 70.5"� i i 0.:;' i�O.G" 1�it�.7" 230.7" ?.'/0.0" 1��VI�C J�.S�� I ��.�� I i�I.�� Gi.J� S�:i.J� ��J.�" 1�4Vid^ 5�,.�;' � ��.3" � i 1 G.`/." S•�!.i" 17�.0` 20�.9" G V�/idC �%.0" �. i 0:?.2" i 2�.:i' i�G.5" 1 G3.7" I ' S01�C�AtiI\G Ci.?MCI?Y 1000 PS� 1500 P5F 2000 PSF 2500 YS� �000 YSE= �500 PSF PI[f:CAPACITY 300�;L(3S I �a07 L6� � EGG']lf:S "l�t i LUS J013 LEIS 1051G LOS (;F{�1SSIS PIF.R I.OADS: f�![c.r.SP�,CIi�IG u�vrrw�orH .ro trc I •rz i,� sc�,�t. -�zo��v � 10Widc 2t.Gt.31b� I ::Ool�Iba 3�61.51bs �:Gt.�ib� 12Y`lidc 2-;91.3ibs � 35�1�lb� ;%�01.�ib: SGbt�Ib: • 14Widc 26�J•t.Glb� � 3&o1.3:ba SO:d.Glba GiO�S.GIb� ' . 1GV`lidc 301��.Gib� � � :,3•ti�;�� SGGJ.OIb: G�0�.G;ba , NOTrS� � � 1.)• . ,PRC•FA�F�ICi-,TEO �l�SS��L��;G::U��D r+��•,��::�TL��%�7G 70'Ci�{E.COt�1CRCTC FOOTli1GS S°cC1FlE0 JN 1'!iG .JAC00SEN N,Oi�A�S SE1'UP ,An�lU:,l. , ' �,� TH�pRC.FAE3SIC'r�7�0?AOS f��i:70 0�r�SS�tr1�LC0 r,DlO l`lSThILCA PCR T;iE MU�A�UFr�CI'UR�RS l�(S�'AI.L.f.'ClO�I ;�S i RUCT!ONS. - �� ai I OTHE„ ;EQUIR��AEN i S h��TO GC r,OUE:R�01'�nS SPeC1FlE0 l�l7HC JAC09��M HOp.1�S , �� . - ' ; ��, �_ t.` �i� � „ ,,. �� 'IER FOOTER SIZING CHART FOR MARRIAGE WALL OPENINGS Qi ' °' (FOR SIDEWALL OPENINGS SEE NOTE Q3 ) , °;4 ��. i.r '�., LOAD SPANS �4 �+! ,;:� SOIL BEARING " '�• CAPACITY PSF 8'-12' 12'-16' 16'-20' 20'-24' 24'-28' 28'-32' '"`� W �i.i� �.`, A � 1000 390 sq. in. 494 sq. in. 597 sq. in. 701 sq. in. 805 sq. in. 908 sq. in. 3�', � 1500 260 sq. in. 329 sq. in. 398 sq. in. 467 sq. in. 536 sq. in. 606 sq. in. ;, �;. 5�,' -�, 2000 195 sq. in. 247 sq. in. 299 sq. in. 351 sq. in. 402 sq. in. 454 sq. in. '�� ?� � 2500 156 sq. in. 197 sq. in. 239 sq. in. 280 sq. in.. 322 sq. in. 363 sq. in, r; ;;:'� MIN. PIER CAP. 2708 Ibs. 3428 Ibs. 4148 Ibs. 4868 tbs. 5588 Ibs. 6308 Ibs. ' `,� �� ,�• +. ,x • LOAD SPANS Q ,�� ` '1t,. a'. a � SOIL SEARING . , , � . , , , , , ;�`�. ', w 8'-12' 12 -16 I6 -20 20 -24 24 -28 28 -32 � q CAPACITY PSF R� �, � 1000 409 sq. in. 519 sq. in. 628 sq. in. 737 sq. in. 847 sq. in. 956 sq. in. ;ti;: ;;' 1500 273 sq. in. 346 sq. in. 419 sq. in. 492 sq. in. 565�sq. in. 638 sq. in. _�t,� .t � 2000 " 205 sq. in. 259 sq. in. 314 sq. in. 369 sq. in. 423 sq. in. 478 sq. in � 2500 164 sq. in. 207 sq. in. 251 sq. in. 295 sq. in. 339 sq. in. 383 sq, in �°' � MIN. PIER CAP. 2841 Ibs. 3601 Ibs. 4361 Ibs. 5121 Ibs. 5881 Ibs. 6641 Ibs. � LOAD SPANS Q �� 1+'� �;�y '1` SOIL BEARING „�5 Q CAPACITY PSF 8 -12' 12'-16' 16'-20' 20'-24' 24'-28' 28'-32' ,;�' ,' � 1000 428 sq. in. 544 sq. in. 659 sq. in. 774 sq. in. 889 sq. in. 1004 sq. in. �}r ' 1500 286 sq. in. 362 sq. in 439 sq. in. 516 sq. in. 593 sq. in. 670 sq. in. ":;r � 2000 214 sq. in. 272 sq. in. 329 sq. in. 387 sq. in. 445 sq. in. 502 sq. in. s' � 2500 171 sq. in. 217 sq. in. 264 sq. in. 310 sq. in. 356 sq. in. 402 sq. in. � � }" • MIN. PIER CAP. 29751bs 37751bs 45751bs 53751bs 61751bs 69751bs �,'"� LOAD SPANS Q '` SOIL BEARING 8'-12' 12'-16' 6'-20' 20'-24' 24'-28' 28'-32' A , CAPACITY PSF � 1000 486 s . ' sq. i . sq. in. 883 sq. in. 1016 sq. in. 1148 sq. in. - � sq. in`. 412 sq. in sq. in. 589 sq. in. 677 sq. in. 766 sq. in. � ' sq. in. 375 sq. in. 442 sq. in. 508 sq. in. 574 sq. in. � 2500 194 sq. in. 247 sq. in. 300 sq. in. 353 sq. in. 4�6 sq. in. 459 sq. in. � NANDZONE III � MIN. PIER CAP. 33�5 �bs 4295 Ibs 5215 Ibs 6135 Ibs 7055 Ibs 7975 Ibs �110 MPH) ALL EXPOSURES 20 PSF ROOF 10 P5F D.L. � NOTES: t�.cucs. O1 SEE DETAIL �B�.PACE SU-01-0001 FOR BlOCI4NC AND ANCHOPoNG Of IAARRIACE YIALL t11111 , OPEtaNGS wIOER 1HAN 49 INCMES. ENpt��i� f�OV11LST/(f- �i�� DAPIA APPROVAL' � QZ SEE NOTES: Q2 .Q3 .AND O4 UNOER TAHL:E I.P�c�w-m-oow. .�` `` ,...... rj�c �•. �voe ul ur+ir w�on+s,us� m.y/�.,r�t Foo�urio�t s+oewati oa�+iNCS rn�r ��`�C�Q;••'V�STERF•�! '''�� APPROVED EY � WCNES,USE 242sq/'�PIEFt FOOiER U DER SIDEWALL ppENINCS ��ES TO 144 _ :'Q� N�. Q ••, ! i �uw.�000 as�sa�e�wwc r�o•o� - � 910334 ' QQ �a��.ow sPU�s, s�e w-o3-o00�.(tono sauas�u�c�asrurs, a� ' �.� .; �___ i SPEpFICAiIONS ABO�E ASSUUE CIEARSPAN OCCURS ON ONE SIOE Of PIER ONLY-, � �� .. �a�sr�oca,�s a+eoTM s�o�s,ADO VALUES US1E0 A80YE FOR EACN CLEARSPAN) " -o •, TATE OF r'�; �NC. � i Qs c�a x+n��oc�,uwsacnaa ro oer�wee n�sa�vuue or� rouR :�O�'• / p '�4' ` FEOERALMANUFACiURED MOME SIiE qt HAVE A$qL BEARWC TEST PERfOiIYED CN YOUR$qL TO DEiFRMINE 1HE YALUE. ��i�� ••N . �� CpN$jpUCTIONAPqSAfEiYSTMqAROS . I �' �� MAR 0 1 1999 JACOBSEN HOMES TME��,s`,��„� �� " ' B.E.M. DATE: 2_s—ss `�`'`�"�` \/ aarar+u.aaaaa�TU�r.�rro ca�sa�n� oR�wwc nnE: PIER FOOiER SI7JNG CHART � I P.O. BOX 368 ��5 OF�N M�tq�F�RWC e�sua wnmaus ua vaoHOCO ro n� FOR MARR. WALL OPENINGS ; SAFETY HARBOR. FlORIOA 34695 ��r��r� �,�,�G�� PHONE (727) 726-113fl �r,canan,�u ua s�c�,�na�oncxs SU-Ot-0030 � 21 ' � ' l H r ADDITIONAL PERIMETER BLOCKING � (m�s e�oaar�c x r+�oano��o e�ocwNC r�a�m w Ms wwuu) ry-------- -� � � o �. � UNDER EAW SiDE OF ALL D(iER10��IOCAiED ON 9DE11'ALtS � � � � � 2 OR 1lOftE 461/2�NIMDOWS � PIERS RECWim AT EAQ�1 E1JD � M!D BE71yEf?I Fa(�H OPE?iN6 ' \ � , ♦ • ♦ ♦ • • � ° ♦ � ♦ ♦ • � . � RECESSED AREAS REQURE PIERS SPACED 64'QG 6UX. � • (18'OR tESS IN DEPiH) �;, rrn.�uc6 a��oErcu�u.o�u�c�wui . ' EACH END OF RECE�AiiEAS - '�' . . i � a . � � N .� R�m�s w/�e�Y�a��ts s�ACm s�'ac.►wc 'fliiS ALSO APPUES TO ALL ENDTUt18AY NINDOWS ;.,; UNLESS SUPPORIFD BY A FRA�IE LIF318ER ':R ' � ; • . -t� 54'•OR 60'lU6 AT 9DEINAIL OR hIARRIAl�WAIl . ' GJ1lmEH'NB AT�D�YA[L OR YARRIA(£YlAtl. � ' 64'QG YAX � --- ------ --- -� ----- �� ------- , � � � . CA�NEfS ALONG SDEWALL OR 11Mf�AGE WALL � (APPIIES i0 BA7N CABINE7S 80�OR f�iEAIER IN LENGIH) I (SAYE BLOC�NG lfAY BE USED FOR IIUL7IPI.E�6 tft'-1MN � ----- � i SPECIAL BLOCKING N07E FOR 15'-4" (184') WIDE FLOOR SECTIONS A , ROVED BY PFRII�IETQt BIAf�(ING IS REQUdtm(►IARRIAGE M1D SIDElYALIS) 64•a�co+�m►uu sr�c NOTE tEVEL FLOOR S15i0�1�t5[(90E11ALL TO SlOEII'ALL OR IdAli�AGE WAIl)BEFORE INSTAWNC PERD�EIIIt BLOGCS r�y 22,2 0 0 6 ��'M INC. �. IWV��y�,�.�Q��j �6�X�6��QZ P��, FEDEMLMAII{1FACNIIECNOME 2 IACAIE BLOOQiG Ut#R PfR1YEIFR JOt5T aR 1Ni}iN 8'OF END COMSTRUCTIONAIIDSAFEiYSTANONIDS 3. PQtNE7Qt BL0f�7G IS RE4UCtED UNDER tA.E ROCRS(AIARRIAGE k 9DE1W15)64'0.G YA)C. � NOTiC� ��'BY:• OASE REV.LEiTFJ� JACOBSEN HOMES �srECS�r�naa Nro ow�wrxs� �.T. 4-12-00 , _ ��.�,��„� o��,� A Wh'AUilS OF.{AC085FT1 YMlLFACI11tQIC � P.o. sox�a ��,a,�,,,�,,,�,�,m� ADDITIONAL BLOCKING SAFETY HARBOR. FLORIDA 34695 I��txr Pdt�ca1c Pu�ras[,t H+o w5t eE DRANM7G NWBER: PHONE (813) 726-1138 IaPT oo�xnH.Nm s[a+�r Fttw at+t�¢ $�—O�—�5 `� :,r �� ALL WIDTHS; AND LENGTHS UP TtJ 52' . . . . • :, � =�� - � • s • • • � .. _ .; • � o� • • • • .. ALL VUIDT. S►;AN�3 LENGTH$ O.VER�2'TO 80' - ' � � ` • • `. � • * • e � a � • • • � � � • • • M�MES 1MTM 5112 ROOF IRE: PER FL4RIQA REGULATIONS 6 syst�Im�for home�n�ths up to 52'end 8 systems#or hvm� over 52'�nd up BO'. ane stiabil�zer pl�Ea and frar�ne fie r�quired at � laterat brecing sy�tem. � . �� NOT�.S: too�b,�s�nptwl�s portN 1.LENGTH OF HOU3E IS THE ACTl1AL BOX 5lZE ��" 2. •=STAB1LiZER PLAT�AND�RAM�TtE LQCATION. �,�pp�`p��j� 3. � = iACATIQN OF ASF MODFL.91fl1'V" �tlwt�nquiie a c snohor. M. {tATEFiAL.$LQNGtTUDiNAL BRACING). 'rbp � a. �II�.00ATION OF MODEL f10'!-�.'V" r....,. ,. : . (L�NGITUDINA�BfZACING aN�.Y). . . �.►, . . • • p. F:'N`bro.!-Mwn ' . . . Pan oa�w�.don tt1M�►6nrt �� C:pR�llt�AAN � J-p1oNIN1 P�fl �a p�QLl�AAPi COE�INEC7dR V�radret U HRAt�TS E�'�LE800P4NG V BRACE • 7U8E A99��l.Y 1AN 1.5��t- ToM 71��AtdC 5.26 TU6E E_'�l'&�ae � IN8�1' O�olbm (1�'9 F-'V'SA�CE 1�Ct�Nt�G M�1El,FSCCPINd TY1�Af+1SV�iSE .Caround Pan � ARM A�.Y ' . I R'1'RAF161l�SE Ai3!I-�IW . COI�rEC1�DR • • ' .F�V FJ�N BRAGI�T --• . ��Y�� REVISED INBTRUGTION88Ix0lQ2 '.� i�p{RAiCfUO!!:p FI�1�ib1A1pATIDIf�1►'aT�t Telephone:831=788�1565 �18�4!l�81t?N O�O�� lNC. Fsx:eslase.eel� M,vrw.orve�he�oloae�.com • , F ,. � , , , � •� ti , �. „ , � •I . � i . i � ,.:I. ., s , , , , . ' . ; ! � , 1)i ir.a i Y � � � l.�i.,_ � yi�:� � i::�R•i; „ .. !�� !. !j?:1 1 �'�`E�4E I � 41'�' '�i i� '�'.I..i...�.l..i. i. }i fi I t�• (� ; i i ., � :i��ll�`i�: �� s. r•tl�til. r•i 1•;i•� i ,•�7j�.� I�i� � �: .I.i�' 1 !'kl�3�i.t:�l°'�� :i. ':� �'L•..:� , �:.l7.1i1��? 1. ':i. fati�; �(! j;:titJl�:l��' E'�'):„ i.!�- I• .i.� 1:..; �...i��ii�!i.� i E 1...�'�i' I: '; '..3 f >> �. t'•t�° i: �..1�. �' �''.!: �� ' �.. . �.�:)i�!i)��ii�,fit � f;l-�,� t•,la.l .i.i'•! i 1. f 't l i;.: i::.l.�E..i t i•�:!°{.i. I... � � 1-•l�::.� l: �� ,^f'::, '^� }: 's:..t�.�;• ±. 1—(i: F'YI... 1. k_i ii�••�I: ;��;�.,,�.,� �: ,::i�i M�"tl�;.t.i: ;��7Vi:: ��:.'�`,.::t ... �"' i ;, i . . 1i. •. �,• �t..i.: :f..s•:.�.��..�•Ei�;!°I.I.�...l...:a„ I• : .� .-_,:..�.:.. .!:,:.:CC?:l.�.St�(?tjtii?;? :��..!.!R.? �)t`. � i��i�at i �..li•�;�� :i.�i. ' �.:i. i.•;I•:;.:�f:.i.ti I—il?i•�..l..c."i?I`�!•`.�} trt!••il•'%�I•'$$:I. '•.�`.•�`>•'3. � . . -,- . �(.i'i��1�... f.}4jt li I(•�.1 ( :; •-,...r., .I.:.} •tt. !. t�? I �.:t!f�i}•'t`!t f�l(:f:(1�.1l�; 1 �.. I: �': i I::.?.,� i::l(�•i1,ilJI'�!i .t>I::.`:i(:1•�;.l.i•' I 3.t.1f�2 'I•'I:..FtiP�I ! !?i•'a !t�•i .t?I•��'t'1•�` . . `,.�e.: •� -`,: :�i'i '� .. i , . . i .?t••?(:�E•)(.1(.:�k {•}/I) i� 1 i 'i �;; 7 ` .i .�..�.''� l.1'•t..)l: .... ,.�.) .l�:�.:�. . �. .1.:... .�i..1....�. �.�'��.. � t�'�...1.� '.d.}�- I'��!: i. i:...I.t�I:..l.} i:;•y Pd�c Fam� CITY OF ZEPHYRHILLS UTILITIES WORK ORDER WATER ACCOUNT NO. DATE: �—(— �J� OWNER/RENTER/BUSINESS: I.,�,� �1 �, L�y'\.r��+ ��„�^.�n(.. CONTACTPERSON: MAIIING ADDRESS: %��Z � uC c� d L�Cff 1�` �-��fi HONE NUMBER: l ZCt��41 �1 i I1 S `�^� --��- j � �7 f EMAIL ADDRESS: SERVICE ADDRE55: b ��z`J �"�C L� �I��C��C ��i� L�;�- �S S , SHUT OFF SERVICE � �WATER TURN ON SERVICE ❑SEWER INSTALL MEfER � ❑GARBAGE READ METER ❑ �IN CITY CHECK METER ❑ ❑OUT CIIY OTHER ❑ DESCRIBE OTHER: :j/� �r�� NUMBER OF UNITS DEPOSIT AMOUNT AMOUNT LAST BILL DATE MISC.CHARGE MElER: FULL :�� c� IIRRIGATION I WORK COMPLETED BY&DATE ORDER TAKEN BY: (�. ��'�f� COMPLETED � ORDER GIVEN BY: / � / / ��l/��_� �.J�:f�(-e_� Revised 9/2010