HomeMy WebLinkAbout15-15967 , _ CI OF ZEPHYRHILLS
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MOBILE HOME SET-UP
PERMIT INFORMATION LOCATION INFORIVIATION
Permit Number: 15967 � Address: 38553 REMORA AVE
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: SLEEPY HOLLOW MHSUB DIV
Est. Value: , Parcel Number: 02-26-21-0260-00000-0710
Improv. Cost: 8,500.00 OWNER INFORMATION
Date Issued: 1/30/2015 Name: DEHRING SALLY ANN
Total Fees: 180.00 Address: 12677 N RED BUD TRL
Amount Paid: 180.00 BUCHANAN MI 49107-9137
Date Paid: 1/30/2015 Phone: (269)591-0351
� Work Desc: REPLACEMENT MOBILE H ME 24 X 54
CONTRACTOR S APPLICATION FEES
' PAL HARBOR ON TRUC I N MOBILE HOME LECTRICAL 40.00 MOBILE HOME SET-UP 60.00
STYLE CREST INC MOBILE HOME ECHANICAL 40.00 MOBILE HOME PLUMBING 40.00
PALM HARBOR CONSTRUCTION
STYLE CREST INC.
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Ins ections Re uired
MOBI E OME ET-UP
MOBILE HOME ELECTRIC
MOBILE HOME A/C
MOBILE HOME PLUMBING
FINAL�-{-,�'-�S'
REINSPECTION FEES: Reinspection fees will c mply with Florida Statute 553.80 (2)(c)when extra inspection
trips are necessary due to any one of the follo ing reasons: a) wrong address b)condemned work resulting
from faulty construction c) repairs or corre ions not made when inspection called d)work not ready for
inspection when called e) permit not poste on job site fl plans not at job site(g) work not accessible
NOTICE: In addition to the requirements of this pe mit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, nd there may be additional permits required from other governmental
entities such as water m nagement, state agencies or federal agencies
The payment of inspection fees shall be made efore any further permits will be issued to the person owning same "�
Complete Plans, Specific tions and Fee Must Accompany Application.
All work shall be pertorme in accordance with City Codes and Ordinances
_
CONTRACTORS SI ATURE PERMIT OFFI
PERMIT EXPIRES IN 6 MO THS WITHOUT APPROVED INSPECTIO
, CALL FOR INSPECT ON - 8 HOUR NOTICE REQUIRED
� PROTEC CARD FROM WEATHER
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ST E CREST INC
RON D E. BONDS SR
C13006070 �
2450 ENTE RISE ST DRAWER A
FRE ONT OH 43420
63-709-8735
I Ronald E. Bonds Sr here y authorize Linda Campbell to act as
my agent in securing electr cal permits in the City of Zephyrhills. I
understand that I am respo sible for the work done by my agent. If
you have any question plea e feel free to call.
_�
Ronald E Bonds Sr. `
�
State of Florida
County of Polk
Sworn to and subscribed b fore me this 20�' day of January 2015
By Ronald E. Bonds Sr. pe sonally known to me.
/� ;:o:�a��°�"��•;, LARRY REED
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'€ MY COMMISSION#FF067324
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Nota SIgT1atL1TE � `�' • 'P�� EXPIRES October30,20,�
'„!F pF'p��,.:�
(407)398•0153 FloridallotarySeNice.cotn
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ST E CREST 1NC
C ES O. THOMAS
J
AC1817820
2450 ENTE RISE ST DRAWER A
FRE ONT OH 43420
63-709-8735
I Charles O. Thomas hereb authorize Linda Campbell to act as my
agent in securing mechani al permits in the City of Zephyrhills. I
understand that I am respo sible for the work done by my agent. If
� you have any question ple e feel free to call.
I
Charles O. Thomas
State of Florida
County of Polk
Sworn to and subscribed b fore me this 20�' day of January 2015
By Charles O. Thomas per onally known to me.
� :?��'"�``°�-�;:. LAR RY R E E D
:�, Q: MY COMMISSION#FF067324
Nota Signature .'�oFF�oP:�• EXPIRES October 30, 2017 ,
(ao7),398•0153 FloridallotaryService.com
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PALM OR CONSTRUCTION
C ES P. ROGERS
605 S. FRONTAGE RD
' PLAN CITY, FL 33563
863-559-3409
I Charles P. Rogers lic se # IH-1025311 hereby
authorize Linda A. Ca bell to act as my agent in signing
� and obtaining building nd plumbing permits until further
notice in the City of Ze hyrhills. If you have any question
please feel free to call e. � - �
� � .
Charles P. Rogers � " , �
,
State of Florida . � . `
County of Hillsborou �
' ' The foregoing instrume t was acknowledged before me
t h i s 1 S t h d a y o f J a n�} 2 0 1 5, b y.C h a r l e s P. R o g e r s w h o
personally known to m . �
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;ip��prPUB4o:, 1..r�RR�1� REED
`� '€ MY COPJIMISSION#FF067324
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� �-.'?���--o�.� EXPiRES October 30,2017
•„OFF�„
Nota Public, State of i lorida �407)398-0153 Floridallotaryservice,com
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813-760-0020 City of Z phyrhills Permit Application FaX-a�a-TSO-ooz� I
_ � 8u0ding Dapartrnent
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' � Date Received ptio�re ntaet(or PertnlWn 863 581 7544
owners Name SALLY ANN DEHRING owner Pnone Number 269-591-0351
I owners�►ddrese 12677 N RED BUD TRL BUCHA N MI p�brPhone Number
Fee Slmple Titleholder Nama N�A Owner Phone Numher
�
I Fee Slmpie Tlilehalder Addroaa wA '
J08 ADDRE$S 38553 REMORA AVE toT r ��
sueomsloN SLEEPY HOLLOW MHE p���ioy 02-26-21-0260-00000-0710
�oar�en Faod vROa�cn T�x Nonc�
WORK PROPOSED e r+tw cOnsrn 8 ADD/ALT Q SIGN Q Q OEMOLISH
" INSTALL REPAIR �
PROPOSED USE � SFR Q COMM Q OTHER �
TYPE OF CONSTRUCTION Q BLOCK Q' FW1ME Q STEEL Q ��r/��� �p � ,
V�(V�
oescwPnoN oF woRK SET AND ANCHOR 20 5 24x54 PALM HARBOR MOBILE HOME � �i1�"�( ►�i,
�tr�v
BUIIDING SlIE 24 X � SQ FOOTAQE 980 HEIGHT 11� �����
�BUILDING S SOOO.00 V lITION OF TOTAL CANSTRUCTION
QELECTRICAL S p �D� AM SERVICE Q PROGRESS ENERGY Q W.R.E.C.
�
�PLUMBING s 500.00 , �J � ��,
. �� _��Tl� a���
�MECHANICAL S 2000.00 � ATION OF MECHANICAL INSTALLATION ( Z � �
QGAS Q ROOFING Q SPECUILTV � OTHER � � (�� .✓�
FINISHEDFLOORELEVATIONS � FLOODZONEAREA QYES NO �7, p {�`� {`]�
✓ �\I �—�
�`7
aui�oER coMPa�n . PALM HARBOR CONSTRUCTION
SIGNATURE I� REGIS7ERFD Y/N �E cuft�ten Y/N
nddr��5 605 S.FRONTAGE RD PLANT ITY u�r,�u IH-1025311
ELECTR�CUW � L�C1ai.�� COMPANY SMECREST �
SIGNATURE r�cis�� Y/N �cuw�. Y f N
Address 2450 ENTERPRISE ST FREMO OH uceruett EC13006070
PLUMBER //�•� �p�y�ppp�y PALM HARBOR CONTRUCTION
SIGNATURE l/'` r�G�57Et+ED Y/N �E cuar�n Y/N
' nddreaa 605 S.FRONTAGE RD PLANT C TY ucenseu IH-1025311
MECHANICAL �'/ `� COMPANY STYLECREST
SIGNATURE �lL r+ECU�nEn Y/N �cuar�n Y/N
Addresa 2450 ENTERPRISE ST FREMON OH ucensen CAC1817820
OTHER COMPANY
SIGNA7URE' �c�sr�o � Y/N �cuw�n Y I N
Addroea LJcense#
RESIDENTIAL Altarh(2)Pbt Plens;(2)seb of Bulking Plans(1)set of Energy Forms;R-0-W P�mit for new coruWction,
Mlnlmum ten(10)worfdng days after submlttal te.Requlred a�slle,ConsWctlon PNans,SMtmwater Plans w/Silt Fence Inslailed,
Sanitary Fadiltles 61 dumpsler;Site Work P it for subdMsloraAarga proJeds
COMMERCIAL AlNach(3)mmplate sets of Bullding Plans plus Life Safety Page;(1)set af Energy Frnms.R-O-W Pertnit for new consWctlon.
Minimum ten(10)woAdng daye after eubmltfal te. Required onsile,ConsWdbn Plans.Stortnwafer Plans w!Silt Fence installed,
Sanlfary Fadlitles a 1 dumpster.Site Work P It for aIl new proJeGs.AII commerdal requirements must meet compliance
SIGN PERMR Atfach(2)sets of Engineered Plans.
"«PROPERTY SURVEY requlred(ar ail NEW nsWcUon. .
Dlrectlone:
Fill aut appliptlon complelely. ' �
Ovmer 8 Contractw sign badc af applicatlon,noharhed
If over S2S00,e NoUce of CommencemeM Is requlred. ( C uppradea over s7500)
" Agenl(for fhe contrador)ar Power of Attomey(for the owner) uld be someone wlth noharfzed leqer hnm owner authorizing same
OVER THE COUNTER PERMrtTING (Front of Appllqtion O )
Reroofs if shingles Sawera Service Uppradas AIC ences(PIoVSurvey/Footage)
DrlvewayrNot aver Counler if on public madways..needs R W
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NCITICE OF DEED RESTRICTIONS: The undersfgned understand that this permit may be subJect to"deed"restrictions"
which may be more restrictive than County regulations. The under igned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPON IBILITIES: 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 Iicensing requirements may apply for the
intended work,they are advised to contact the Pasco County Buildi g Inspection Division--Licensing Section at 727-847-
8009. Furthermore, if the owner has h(red a contractor or con ctors, he is advised to have the contractor(s) sign
portions of the"contractor Block°of this application for which ihey will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properiy licens d and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACTlUTILITIES IMPACT AND RESOUR E RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees ma apply ta the construction of new buildings,change of
use in existing buildings, or expansion of existing buildings,as sp cified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands,that suc fees,;as may be due,will be identified at the time of
permitting. It is further understood that Transportatlon Impact Fee 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 Issuan . Furthermore, ff Pasco County Water/Sewer Impact
fees are due,they must be paid prior to permit issuance in accorda ce with applicable Pasco County ordinances.
CONSTRUCTION LfEN L.f�W(Chapter 773,Florida Statutes,as mended): If valuation of work is$2,500.00 or more,I
certify ihat I, the applicant, have been provided with a copy o the "Florida Construction Lien Law—Homeowner's
Protection Guide"prepared by the Florida Department of Agricultu e and Consumer Affairs. If the applicant is someone
other than the"owner", I certify that I have obtained a copy of the a ove 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 Info mation in this application is accurate and that all work
will be done in compliance with all applicable laws regulating cons ruction,zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I cerlify that no work or installation has
commenced prior to issuance of a permit and that all work will b performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and lan development regulations in the jurisdiction. I also
certify that I understand that the regulations of other government a encies may apply to the intended work, and that it is
my responsibility to identify what actions I must take to be in compli nce. Such agencies include but are not limited to:
- Department of Environmental Protection-Cypress Bay eads, Weiland Areas and Environmentally Sensitive
Lands,WatedWastewater Treatment.
- Southwest Florida Water Management District-W Is, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls,Docks,Navigable aterways.
- Department of Health 8 Rehabilitative Services/Envi nmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks. '
- US Environmental Protection Agency-Asbestos abatem nt.
- Federal Aviation Authority-Runways.
I understand lhat the following restrictions apply to the use of flll:�
- Use of fill is not allowed in Flood Zone"V°unless expre sly 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 pe mitting which is prepared by a professional engineer
licensed by the State of Florida.
- If the fill material is ta be used in Flood Zone "A" in onnection with a permitted building using stem wall
construction,I certify that fill will be used only to fill the rea within the stem wall.
- If fill material is to be used in any area, I certify th t use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect ad cent properties,the owner may be cited for violating
the conditions of the building permit issued under the ltached permit application,for lots less than one(1)
acre which are elevated by flll,an engineered drainage lan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to in orm the owner of the permiBing conditions set forth in
this affidavit prior to commencing construction. I understand that separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other instal ations not specifically inciuded in the application. A
permit issued shall be construed to be a license to proceed with th work and not as authority to violate,cancel,alter,or
set aside any provisions of the technical codes,nor shall issuance f a permit prevent the Buildirig Official from thereafter
requiring a correction of errors in plans,construction or violations o any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within si months of permit issuance,or if work authorized by
the permit is suspended or abandoned for a period of six(6)month after the time the work is commenced. An extension
may be requested, in writing,from the Building Official for a perio not tb exceed ninety(90)days and will demonstrate
justifiable cause for the extension. If work ceases for ninety(90)co secutive days,th�Job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOT CE OF COMMENCEMENT Mp►Y RESULT IN YOUR
PAYING TWICE FOR IMPROVEIIAENTS TO YOUR PROPERTY. 1 YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDIN YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.11 03) ' I
OWNER OR AGENT �'�'�_ CONTRACT R �
Subscdbed and swom to(or affirmed)befor me this Subscdbed a d swom to(or atfirtned)before me tltis
by by
Who Is/are persanally knovm lo me or has/have produced Who Is/are p rsonally known to me or hasRiave produced
Identlficadon, as Identifiqtion.
� Notary Public Nofary Public
Cammis "tY�"•: �OEL E.BACON Commission o.
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�� a= Expires June 29,2018 '
Name of / Name of No ry typed,pdnted or stamped
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Ci4y af Zephyrhills
BUTLD G PI,AN REVIEW C4MMlENTS
CantractoriHomeowner: i. R �0#►?ST�VGT O
Date Received: � �- 't,i -- j
sxt�: 3t 3 R��oRA �vE
Permit Type: �6T t�10 i�CW .� �D yi x S �/F'� �
Approved w/no comments: Appraved Ithe below comments: ❑ Deuied withe below comments: ❑
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This comment she�t sh be kept with the permit andJ,or plans.
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Kalvi tzer—Pl s Examiner Date �ontractor andtor Homeowner
'I (Required when comments are present}
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TNa Instrumenl Prepared By. '
k� LINDA CAMPBELL �
��fe$'P.o.Box�o7a Rept:1655133 Rec: 10.00
KATHLEEN, F� �aas DS: 0.00 IT: 0.00-
ND7ICEOFCOflIMENCE6;ENT 01/ji/201$ S. P. i Dpty Cle�k
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CQUNIY OF '
THE UNDERSIGNEO hemby gtves�otl�N�at improve nt w;ll ho mado lo ccrtain real p�ope:ly,end in zow�lonce�+ith
CM�pisr 7t9,Florid.i Staartos,uw fdlovAnB��fomqUo�s i Drovtded In tht�Na�e of Canmer�men�
t.DescripQort of preporty.Qaga1 desuiptlon ol p�operty, nd�aeet addross If awimble)
D2-2&21-0260-00000-0710 SLEEPY HO LOW MOBILE ESTA7ES RESIDENTIAL COOP LOT 71
2������p��a���en�38553 REM RA AVE
set-up and anchor mobile home with ele 'c,plumbing and a/c
3,Owner infarmattwi
a.Nemaand address:SALLY ANN DEHRING �?67T N.RE'.7 BUD TRAIL BUGHANAN,MI 49107-9137 •
b,Int�mstlnprop3rry: OWNER
a Nama end address of tcc�aimp:otiUahdder(U o�hs than owner): _
4'Co�tt�t�mo antl atdrrsx PALM HARBOR C NSTRUCTION CHARLES P.ROGERS 805 S.FRONTACiE RD
b. Phono numbc,r, 813-752-1368 ; • PLANT CITY,FL 33566
5.Surery �
8.Na1tta and etldres9: N/A
b.AmountofbondS ' PqULq 5.0'NE1L,Ph.D:PRSCO CLERK & COMPTROLLER
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b. Phone nutnbcr:
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e. Name and addres9: NIA
b. Phone num�r:
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WaRNtNG TO 04YNER: AP�Y PAYM.ENT3 A1ADE BY THE OWNFA AFTER THE FJfF�RA��ON OF THE NOTiCE OF
COM�AEICCEA9ENT ARE CONSIDEREO �MAROPE PAYMEPff3 UNDER CHhPTER 713, PART 1, SECTIOhI 713.13,
FLORIOA STATUfES,AND CAN RESULT IN YOU PAYING TV17CE FOR IA9PROVENENTS TO YOUR RROPERTY. A
in�Pecron,CP YOV�I�TE�D TOOBTAIBIEP�N�ci+ ino eonsu�wirr+voua�eNOER OR�ANBATTORI�CY DEfORE
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ON FILE OR OF PUBLIC RECORD IN THIS 0 FICE � , , •a �
WITNESS MY HAND D OFFICIAL SEAL TH S � ° In C�oetlYe.r�.ue �
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FLORIDA&NERGY�FFf i�1+fCY CODC FOR BUILDINCi CQNSTRUCI'101V
F�RM 600C-0i Residentiat Lim#ed Appiic�tions F�rescriptive Method C CE�tTRAI.4 5 6
Sma@ 1lddifions,Rpnovatiatss�Buiiding SysEems ,
CumpTmnrs+u�111�+odCofCl�P�6UN�Fbo+�E�t�tE�cian.YC�demaY4e byUevsedFo�fiQOG�1loredd�ai�D�refedate�.sile-iu�9edGanpo.'te�ofm�dacnaedtgmes,aral
�IMh�otsb' 8nd Atatsd'r�emethodcma iv cxedFwmbO(iB81w80(tA�tN.
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PROJECT NAME: Sui�pER: �tLE$ P. RC7GER8
I AMD AQDR�SSc 38553 remora ave __ ��RMrrnN� CI.1JUfAT� � ��
� aF�cE: �T}( OF ZEP N�: a s X
uwNER: sally ann dehring p�ro�rNQ -;��ua�nicT�a+�o.:�rl� p��]
s�v.idnorrrar��ra�usrw�r�tu�s�oos��e�eta�a�,a� ��uvare¢:,�,�,��,fan�sc�.scz�,ascae�yonyms�ecorn���n��,,��oe,ee�yu�,a
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3180QYEf�hy�1tS t0�I1L�S�i��S C�Mil@n OINIR11CiCilqvSy5�Cl1161I6�
Please Print CK
1. Aenovatian,Addi�lon,New System or Man actured Home 1. MANUFACTURED _
2 Single family detached or Multifamily attac 2. SFD _ __
3. If Metltifamily-Rlo.af units coverer7 6y th�s u6mission 3. _._.
d. Cortditioned flaor area t5q.it.) , 4. .__,,
5_ Predominanct eave overhang{##.} 5. ,_
6. Glass area and type: �sng�o a�na ooub�B ra„e
a. Cleaf g1asS 6a_ __ __ sc�.fi. Sq.�t. -- -
b. Tini,fifrn or sol�r screen 5b. , sq.ft. sq_ft. _____
7. Pereentage of glass to#loor area 7. . °!o
8. F�var type and insulafian:
a. Slab-on-grade(R-va�ue) 8a. R= lin.ft.
� b_ Wood,raised{I�-value) Sb. R= sq.ff_
c. Wood,comman (R-�al��e) 8c. R= - - sq.ft. .
'� d. Co�crefe,raised(R-v�z{ue} &1. R- _ sq_ff.
e. Concrete,comman{R-value) 8e. R= sq.ft.
� 9. Wal1 type e�nd insulation:
a. Eicterior:
1. Masanry(Insulation R-vatue) 9a-i R_ _ sq,ft. .
2. Waod frame(Insttl�tian R-value) 9a-2 R= sq. ft. . -
b. Adjacer►t:
'�. F,RA30TIl�f�IR:3!lIBt101i FZ`Y@IUC� $�}-1 �c SC�. � _ .
2. Waod frame(Insulation R-value} 9b-2 R= sq. ft. _ „�,.,
c. Marriage Watls of Multiple Uniis'{Yesll�to� 9c
10. Ceiting typ�and insuiatinn:
a. under attic pnsulation Fi-valuej 10a. R- sq.R_
b. Singte assembfy{Insulation R-valuej �tDb. i�= sq.ft.
17. Coaling sys#emY
(TY()es:CCnftd�,t�om an�t,Dackage terminal A. ..(fes.Axi.ctinp,nnna) »_ ry�: CENTRAL __
SEER/EER: 13 _�ON
72 Heating system':{Typ�:heat pump,���.st�P,nam ��,�.p.�as, �2. '�y�se: ELEGT STRI P
gas h.p.,room ar pTAG,existing,nartej � HSPFlGOP/AFU�:_. �a_��
73.Air Distribution Systcm':
a. Backflov�r clamper ar single package sysiem '{YesllVo} �i 3a_ �$_
b. pucts on marriage walls adcquately sealed (YeslNo) �s6. YES _
14.Hvt vvater system: 'J 4. Type: _
;�ypes:elec.,natural gas,other,ewsting,none) EF:
�Pertalns ta marx,facivred horrses with sife instattcd cost�pvnen .
(fi9Tphy rx!etH ihat the lans and epaciticaiioM:oovorod by�hc lcutation Are in tter+ewct�iasarnle}c�atlwltunywngtLRfbyUffi sESt�ntpnasxx
comp�iancewit�ithe�ksr'�aEn Gode. m'ththQFbri'�r�ncrgyCade. � tf�,abu�rhrgm+Ii6e
VHEPAREp�y:LINL��C�MPBELL.. Qa ; 1-15-15 _ �R����ur�omp�ancema , i ., . , S.
I heeeby ccxtify th.�t this F�uihling is f�cornpiance with the Florrcia 6�er Gode, suunxu�o ic+n�, ? �
cn,+r��as�r, LINDA CAMPBELL on . 1-15-'15 aa�:�
-t-
{,'limafe 2onPS 4 � 6
TAEGE6G1:Pf1�St�T1YER80R�lEHTSHKiSYAlLA6�tONS� Ptardt�sj,l38t4YAiKlNSTUE�St1NG8U1tDaK?BIWD�i7E�{NST141LFbCtt6�lRt�ptE�iTS#ii��UFAC�tfA�H�.
� 1ERtpIIUA! lNSULA170N �BItR� RtSTALLED
_ t%�MPONEAff EdSUtAliON Ii�,RTALM.Eb C-autpMENr EfFiGiEMtT EFFw7ENCY
C.onercle Btock " R�� . Carnral NC-5'plft SEEIi - 10.0 SEER =
m Ftame,2"x 4' R 17 �
� Frart�e�2"x 6" Fi-f9 � -��9. SFER = 8.7 SEER --
3 Cornmon,f rarne �t-11 � Rc�m un9t or i�'1'AG EEF� :- 8.5' EEfi -
Common.Masanry R-3
Under AIGG R-30
ElectrlC Resi� At+iY
� S'stgte Assentt}!y,Endosed c,� Heat putnp-SpSt HSPF a &.8 ttSPF ; �
� F�amc R-19 � -Sisgle F'�g. NSPF = 6.6 !{SPF -
� N(etat Patts R-i3 u'i
U Single As58tnb[y,Open !�-1Q ' x Roan unl or PTHP Cf3P � 2.?' HSPF/ -
t;amm�dn.Fr-�un9 R•'11 �P
°a3 �.naduratorpropane AFUE = JB AFUE _
� Slab-orr�grade M1!o fUltlnimum - �uel Oi! AFUE -= .78 A�=UUE _
� A2tised Woott R-ii _
O RaLsecF Gbncrete R-C
�-'r. Comriusn,Prame R-.s� � ti� Ei�C�tC HeSts�ance F.F' _ .88 F� _
c~.� irf�ditiotted sQacc R� s� GaS: !+l�tnrai ar C.P. EF = .54 EF Q
o In c�ncitioned space No mipmun Fue!O�'I k'F = .54 EF =
'Sue Tatila 6�fr7
7ABLE 8�2: PRESL�I REQUIRE6�! �QR� 1N ADt1f'�10NS 't
M+a.�n�un to floor ar��IlonrBd fs sekdcd and solas h2at coefC�ptt Meximum%x tr�stalted%_
GtASS"TYAE,OVEF�HANG,ANp SpLAR H T GAIN GOEFFK;IFl�'r'AEQLiIpEb FOR GIASS PERC�N�LAGE ALLdWED
UA TO 2095 UP TO 3 96 UP TO 4096 UP TQ S�°k
Stngie Dpubla Sdn,�w om+��v ��ytu tauble Sir�gfe ' tk,uWe
9'-_8J t?=.78 �"-.87 7=.78 3'-_87 2=.78 4-.B'7 3'-.78
0'-_75 1' .75 Q`-.81 2'-.7� t'-S1 3`-.7�s 2=.$`t
o-.s� y'-.� n�_ �se �-.s� ��-.�w
�r-� t�-.ss a�-.�
Get cx�t3f3ed SHGC iram the manc�factarer nr use u1ts: Single dear SNGC=.BJ,dnubie de�ar SHGC=.78,and singh�ti�rt SHGC=J5.
T11BLE 6C�3 MUBhfWA F�QWiiEh�NfS FOR ALL PACKA .
!GOMi�oNENt'S SEC7 REfiU1REMENTS , CFfEGK
EXtetyor d0[ht5�CraCkS 1'o he c� _aStrioved Oi athBrvuise seei9d. . ,
Ead�or 4lri�arrs d�[lanrs F>46.i Ma�s.D.3 ctm/ _i!. hdour area:S chs�tsq.Si�ar area.
Sole&T�es 606.1 5ole plales and raCwns Ihrottgh top lrlates af e�cterior vrdlls m,st be aratwi -
RQtYtCSad ` htin 008.t 7 tG[BiEtl With O f�etfdi�fulS{tW8 6ftEfliBt�/&s BINOW�.
MuEti-S�taY Mtr�rseS GQ6.1 A'v b8tr19t ott tx�it e4er'b}lloor cavi#y betwEen f3ooi8.
EXhaust Fans t006�1 Exhaust iarts verd !a urx:or�t[onad s�sh8(I have dacnpeis,excegz fa comtwsticx►
devices with ettea c�chaust ductuoork.
GanbusiKm 6�.1 Gomb�tion spaee tI W&t�hRdtitSP sys#eef�.e m�ust t»providad wvith outside ernu[n+�liW s ait,
Haatina . 8XL'E�1101�l�AG1 i' �8t1G85. . -
Weter Hoat�s si2i c�,�yw;u,ea�cre tequiiements fi Tab1e 6�12 SwRch or dearty marlred circuit breSker(ele�tric}
. . or ff(ctas�m oWtle,�l, E�,tgn! I�.a'htnt�-in�eat trap revui Enr vertical,�tipg tisers.
Swimming 812.1 Spas 8 hested rraust havc covers(exvepi soLir healed). tJnn-commercia!pools musl frare a
POO1s dc Spas . Pqtn�timEr.G85 &j�t F198fErt_�havA rtthirm�m dwrmat aifioionhi oi?0'x+. .
Noc Woter r�pr.a ti12.1 aFatiflrt is tor hot wattx Girc�tit�nt sw;l�r.m5{tnckidtn�hea#tecav_e�r tm"�its,`_.
Showor I�eads . Bi2.1 Water flow must be reatdacd ta no more than 2.5 gallons per minule at BO PSIC.
HVAC� SttT_t' A8 ducts.fittings,m i�si equiprneM and ptr.num c�nmbers shalf be meFhari�cally atlached,
Ctx�strus�l�on, s�aleti.insu�ied installed tn atxordance w,1�t#ec tx'steria ut S�ction 61tF.�. �t+cts e�atUcs muat 6e
Insuta6wl,��nstaiietian a�suk�ted to a min' um d F1-G, •
Erivnc cormae e+ura se{�arate teadiy 1�Is manuai os antomafic therrnostat tor ead�systarn_
���� _
LOnTablcEGf!►dc�effieA�v�atueddiei�ulaficm6drgad�lm�cpnponmltard e�qrkvdsd�heeqtipmentbeigin�aiied.plFNraif�ea�ul�i�a8�nxai�ote�d&cemvianmt+�uest�d.
�arde�pePmentn�hsxbe�ge�ddec}nare��etln�6eldtbtmi�. ,
a.niM7lix�kSn�l.v�d,�pc�nogcet,�c,�w�lorim�mra�ea� �a5idv��.Ta�iff,ea�a��assu�Idours,s�rnjgiassdaxsanay(�s�orpanetsn�lepicarnad�r�wcr�raimor
gl�sana�da�ma+epr�wias&�hdL w�Ong�ssine�itgeuarior.tals'st�iyrmwrea �ahymead�n.ana,r�nleq�lbffist�fa�a►l��riszrybesAY�b«t+4�mw,�saea oivideU�e�i
¢xsa�b�ityUe�tardSmcdAoorar�ol�ead�6an6id[pI�6y1001opetlie Fmdihei3rc�►9�P����Y���P�l8�Sa1Tah4e6G2A�e�aipfivesaieguenh'���9�
(Soujea�lepane}a�d�e�9(�il�ired�as�hart�arga�welbr� . FBragven�Stypeandarefi�tg,Ihar�was►msoFashffitgaincaaif+deriiow�edtsa�'md.�tg�ss�sirdo�s�nddoas
praear,lyinfie��ra8sdtieMi�ea�nlbai�pp[e�aied'nCeait�ondorwtie�eto .��eare�t�andsa�rhs4{�inme.e�nmr���arc«,T�sbse2t�ncxrgaasman�unUSCrn�s�e�vt�ad
fmmretthn�anshstns�a�++�+*e5��'y�YYW�.iheovethanp{OHj isi�aarre.l�eiprn6p�darly(�fiihetacedfieglaabapoini�uml�EteoiAeirtqsl9d�a[fheove�g
3.F�f-pVAt10NSOr1Y.E�ae�rd�ssneedsbsreetlhefafiaai�,�wan�s, t��D?midsabrt,�tt�ooe�mayheu�iag(�sa�eas�{ndrs�url�feer�lsaaatavtwtw�h�Aardw�os�taw�edge
dcesnotedenatuAia.ra�arert5nrn9�eorefi�g.r�sar�be�r�aViald� rr�rotr�weria�st6ee�ers5rt�e�paneSted�h9e-panecl�a�epa�eGNea
d�H�SYS1�,i.Cm�pipe�nt�ewsy�an's"ss�edias�ect�a�afed . �
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_� � PERMIT WClRK$HEET page � of 2 �
PERMIT NUM�ER '
''"� !� New Home (� Used Home [j
InstalEer �.�Qd"�c�'_5 I . �o c g,� � L.icense# .�Ct " ��`�J� � � � �
Home installed to the Manufacturer's Installation Manual
Address af hame 3� �,� � � � M��'+G� �11� � Nome is ins#alled in accardance w�th Rule 95-C []
being installed
��?(�,,� �_ Single wide ❑ Wind Zone II [v� Wind Zone!ll ❑
(Vlanufacturer _ ��,I►� ��!`(�C1� Length x width .�� � � Double wide ❑ Installation Decal# 71� l� ,
NaFE: if home�s a sing/e wide filt out one half of fhe 6locking plan TripletQuad ❑ Serial# �� �
if home is a trlple or quad wlde skefah in remainder of home
1 understand�.ateral Arm Sysfems cannot be used on any home(new ar used} PIER SPACING TABLE FOR USEa HOMES
where the sidewall ties exceed 5 ft 4 in.
lnstaltec's initials � ��— � F�� ,} „ , < < „ n � ,� ,� ,< <
bearing size i8 x 16 'E81/2 x 981/2' 20'x 20 22 x 22` 24 X 24 26 x 26'
Typical pier spacing capacity �{sq in) ���8) (342) (400) (484)* (578)* , (676)
f iet��
2' �~~« s
I Show loca#ions of Longitudinal and Lateral Systems s
Iongttudlnai (use dark lines to show fhese lacations� s
s
s
s
� * interpoiated from Ruie 15G1 pier spacing tabte.
PlER PAD&IZE3�
_ _ i-beam pier pad size I 7•S x�S.� a ze n _
x
Perimeier ler ad size x
, � x
.... . .
___ _______ C l'� ��S._T�l'�—�k—`�---.�,.�0�.�5 c n�G _ ." . Other pier pad sizes �Q ,� � (� x . "`
----------=- ----------- � - -----____------
��..��� - .�_ �� {requlred by the mfq.} x
x
Draw the approximate locations of marriage x
wail apenings 4 foot or greater. Use this x
mertlege well plers wlthln 2'of end of home per Rule 16C �"'�"'� SYmbol to show the piers. X
X
E,ist att marriage walt apenings�reater than 4 foat x
and their pier pad sizes below. aNCHORS �
_ ,_ ___.___ _ ... __ __..., . ._ ... _._. �pening Pier pad size
.�... ._ -- -_.. __. ._ _.. ._ _.,.__ __
-�--.-..._._._...._ _. _..,..__ __.,..__ __ ..... .. _..,._._.___..._. _. _ ,_.,.........._......_. __. . 4 ft 5 ft -
.. .----............._.., .... __ .. ----_..._... _:...- ---_......__.__ _ ._ ._ - -
._....__......_ --- - .� _...._ --- ..� ._
_._. •-__•._. -_. _..__._ .... ...___. __ __. � .._.._. ._._ " � FRAME TIES
- �•--•••-._... ••.___ __,...__ _ ....--- .,...----......-••. � ._. _____..._•--
. .. ..__..____ ._ _ ._
..�....__....�. _.. _.._._�__..- ---- .,. .. .�...._...__.� .._. within 2'of end of hom�
- � ' spaced at 5'4"ac
•-. ,.. ..._ _.....�.---__ •••• • .._ __._..,...... ..... ._ .., ......__.:.___. .... _ _..... TIEDOWN COMP4NENT8 OTHEii TIES�
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__ _._.._�__.__ . ._.___._... _ ._. ._ _.__._ ._ . ._ ._._.___._._ .._ ._._ __ Longitud)�►al Sfablllzing Device(LSD) Sidewall
' Manufacturer Longitudinal
- Lo»gftudina!Stabilliing Device wl Latera!Arms Marriage wall
u �' m � Manufac#urer M l N c..aPTE Wi�4-N Shearwall
� -- — — — — �
� �- PERMIT WORKSHEET page 2 of 2
PERMIT NUMBER
Site Preparatlon
Debris and organic material removed ���
The pocket penetrometer tests are rounded down to psf Water drainage: Natural Swale Pad�Other
or check here to declare 1000 Ib. soii _,�without testing. ,
Fastening multt wlde units �
X X X
Floor: Type Fastener:_L 4G: Length: �.` Spacinq: �.G "�q�
Walls: Type Fastener: �.��t,J Length: y " Spacing: ,�°�_�
POCKET PENETROMETER TESTING METHOD Roof: Type Fastener: �.�1J Length: °r Spacing: �� �• o:�
For used homes a min. 30 gauqe, 8"wide, galvanized metal�strip
1. Test the perimeter of the home at 6 locations. will be centered over the peak of the roof and fastened with galv.
roofing nails at 2"on center on both sides of the centerline.
2. Take the reading at the depth of the footer. .
,GaBket(weatherprooflng requlrement)
3. Using 500 Ib. increments,take the lowest
readin�and round down to that increment. I understand a properly installed gasket is a requirement of all new and used
homes and that condensation, mold, meldew and buckled marriage walls are
a result of a poorly installed or no gasket being installed. I understand a strip
X X X of tape will not serve as a gasket.
� Installer's initials � �
Type gasket�c���,!` �e�. 1 Installed:
The results of the torque probe test is ��v inch pounds or check Pg. Between Floors Yes _t.�
here if you are declaring 5'anchors without testing . A test Between.Walls Yes ,�
showing 275 inch pounds or less vuill require 4 foot anchors. Bottom of_ridgebeam Yes �l _ _
Note: A state approved lateral arm system is being used and 4 ft. _
anc ors are a owe a e si ewa oca ions. un ers an ea erproo ng
anchors are required at all centerline tie points where the torque test
readit�g is 275 or less and where the mobile home manufacturer may The bottomboard uvill be repaired and/or taped. Yes � . Pg.
requires anchors with 4000 Ib holding capacity, Siding on units.is installed to manufacturer's specifications. Yes +✓
C.k Installer's initials Fireplace chimney installed so as not to allow intrusion of rain water. Yes ✓'
ALL TESTS MUST BE PERFORMED BY A LICENSED INSTALLER M scellaneous
Installer Name �If�.L�,f�c°� �- �Q�t �'� Skirtinq to be lnstailed. Yes �d' No
Dryer vent installed outside of.skirting. Yes_�N/A -
Date Tested Range downflow vent installed outside of skirting. Yes�_N/A �
Drain lines supported at 4 foot intervals. Yes_�_
Electrical crossovers protect�d. Yes �`
Other:
' Electrlcal
Connect electrical conductors between multi-wide units, 6ut not to the main power
source. This includes the bondinq wire between mult-wide units. P9• Installer verifies all information given with this permit worksheet
Plumbing is accurate and true based on.the
Connect all sewer drains to an existing sewer tap or septic tank. P�. manufacturer's installation instructio s and or Rule 15C-1 &2
Connect all potable water supply piping to an existing wate�meter,water tap,or other Installer Signature � _ Date /'- /5-/,�
iindependent water supply systems, Pg. _ . ,
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BLOCI4NG LOCATIONS SHOWN ARE CONSIDERED iYPICAL BLOCKS MAY BE MOVED FROM LOCATION SHOWN(WfTH THE IXCEPTION OF SHEARWALL OR CALUMN LOCATIONS)AS LONG AS THE MA)(IMUI�A SPACING IS NOT FXCEEDED,
UNLESS OTHERWISED SPECIFIED IN THE NOTES BELOW.THE DISTANCE BEfWEEN ANl'A0.IACENT PIERS MHY DEVIATE FROM THE LISTED SPACING BY 10%,SO LONG AS 7HE OVERALL AVERAGE DISTANCE BEfYVEEN PIERS IS EQUAL .§ g
TO OR LESS TW1N THE LISTED SPACING.SEE SECTION 3 IN THE PALM HARBOR HOMES INSTALLATION MANUAL FOR MORE SPECIFICS ON BLOCKING THE HOME. � � S �� S $���Y ��� p
COLUMN LOADS � � � ��� � ��� �� �
1Q =1906 LBS. � c�
Q2 =5890 LBS. �� � � �'�� � � ���O
sa•� � a
O3 =2944 LBS. Z4 "`D°'""'
s-a• za o �
4Q =1310 LBS. �1 "�"° � � `� ��
�5 =1310 LBS. 1 . • ` . • . . • SP nvcnit�ao.vrunEav 4. LL ��
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24 �-5'-0' Zq Perimeter Clocking rrot required � � 4 2 PAitK:
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� NAME: �
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INSTALLIN6 A HOME CAN BE VBtY DANGEROUS,ONLY QUALIFlED PERSONNEISHWLD EVER ATiEMPT TO INSTALLA FiOME. � cq S�E „a,,,o,,,m,o,�„b
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�� � � H,UAYW�20NE
1. BIOCqNO SPACINO BASED ON 20PSF LNE LOAD ON ROOF AND 1000 PSF 301L BEARINO CAPACfTY. 7 3TABL�t 9YSTEM PER PALM WIRBOR IN3TALLATION MAWUAL,AND ALL SIDEWALL ANCHORS ARE SPACED AT � � �
2. CANCRETE BLOCK3 ARE ONLY RATED AT 8000 POUlIDS,8000 POUND PIER9 OR HIGHER MU3T BE 5�4'MNOAftIM.F9IlR F00T GROUND ANCHIX2 MAY BE USED IXCEPf WHERE PALM HARBOR INBTALLATION MANUAL
DOUBLE BLOCI�D. SPECIFlES DIFFEi7Qdi. s����
3. BLOCqNO REQUIREDAT OPENINO LESS THAN 48'IN WIDTH ONLYTO bW(E NON-0PERATIONAL & R 19 T}�RESPONSIBILfTY OFTHE�EALER AND/0R MSTALLFR TO CERfIFY TT1AT ANY BLOCIONO MIDIOR � B�a�o�y,�
DOOR3 OPERATIONAL PFRIMETER SUPPORT9 ARE REOUIRFD ON EACH 31UE OF ALL OPENINGS GREATER FWNDATION PRIM(3Z OR ANY OTHER�AGRAM 3UPPLIFD FOR ANY SRE IN9TALUTION,CORREUTE m
7}WJ 48'(IE.SLIDINO GLA33 DOOR3,BOX BAY WINDOWS,RECES4m FNTRIES,EiC_)REFER TO THE WITH T}iE UNR ORDERED AND BEINO SEf AS WELL AS THE CONDfT10NS OF THE SfTE.THE MANUFACTURER W � o�w+m ra+m
IN3TALLATION MANUAL FOR MORE 3PECIFlC3. WILL NOT BE LWBLE PoR DAAUGES ARISINO FROM FAtlLRE OF THE OEALER ANQlOR INSTALJ.ER TO g ����
4. MFRRNOE LINE BLOCIQNO ONLY REQUIRED UNDER WALL MNRRIAGE L1NE WALL AREAS. MAI�CERTAIN lW1T THE CONiRACTORIINSTALLER HAS T}�CORRECT DIA6RMA3,REGARDLE35 OF WHAT WA9 J R J �iND�����
5. FOR WIND ZONE II AND III INSfILLlATIONS,A PIER IS REWIR�UNDER THE SHEARWALLS'WHERE SUPPIlm BY TNE MAUFACTURER THE MANUFACTURER ASSUM�S NO RESPONSIBIUTY OR LIABI�JTY FOR T}� � B�awo c�v�arv
7HEYATfACHT0THE510EWALLTHESESHENiWALLSAREM0ICATEDASDARI(ENEWNWALL30NTHE DESIGNOFTF�BLOCqNGMIDIORFWMDATION. q�-,y� � �LK��
FlOOR PLAN. 9. FOR MORE SPECIFIC MFORMATION REFER TO THE IN6LLLLATION M!W UAL
8. A&S PIER PAD SIZES AND CAPACRIES&LSm ON WFORMATION PROVIDm BY TIANUFACNREO HOUSINO f 0.ALL SEf11P MUST COMPLY WfTH THE PALM FiAHBOR HOAIES INSTALlATiON MANUAL. ti�i�9
FOUNDATIONSYSTFM9' LI��OO e�Ertoci
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` Patent Number
0 6622439
�
O FEDERAL M11FtUfACTURED� A��h��,�� /fiG
U HOUSWG CONSTRUCTION�
� 8 SAFETY STANDARDS ;p
� 02 m n a f f n f d LLB Lon itudina and
� p L Br e A rove for F or'da
2/19/2010 Revis d: 10/27/04 ,
Note: Your set must be designed by a R gistered Professional Engineer if ali or one of the
following conditions occur:
Loca6on is within 1,500 fee of Coast Roof eaves exceeds 16"
� Pier Height exceeds 48" Main beam spacing exceeds 99.5"
�� , Sidewall height exceeds 9 " ,
� Refer to the Home Manufacturer I stallation Instructions for pier locations. 6" Disc
I anchors 48" long with vertical ties are required at maximum 5'-4" center along both
i sidewalls starting a maximum of 2'-0'in from each end of the home. Vertical ties must be
; used at all connection points furnish d by the home manufacturer. Centerline anchors to
,i be sized according to soil torque con ition. Any manufacturer's specifications for sidewall
�i anchor loads in excess oi4,000 Ibs r quire a 5'anchor.
i�
!' 2 Refer to the Systems Placement PI ns for the location of Longitudinal Lateral Bracing
�� System.. (See Attached). Each ystem is required to have a frame tie and stabilizer �
�i attached at each lateral arm stabilizi g location.
j� s Remove turfto expose firm soil at ea h SD3 pad location.
I: a Attach tube clip to SD3 pier pads(s e Detail Assembl Drawin center ad under
�� Y 9) p beam,
;I level pad. Angle Drive Pins may be riven vertically through four(4)slots in SD3 pier pad
�� now or after home is totally set. Angl drive pins may be driven up to ten degrees(10)off of
�� vertical. If you choose to drive pi s after home is set, do not cover slots in pier pad.
16"Drive pins must be used in Florid .
i 5 Level home on concrete blocks or de uxe steel pier by Minute Man.
, �, b Install Longitudinal and Lateral Bra ng in accordance with Systems Placement Plan and
�; Detail Assembly Drawing.
i�
i� � Install vertical anchors,frame ties a d stabilizers at each lateral arm system location..
i Thank you for using Minute Man Products, nc. If you have any questions, please call Toll Free
I� at(8 0)438-7277. MMAP007,2 R-4
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;; MADE N THE USA
I� 305 We�t King St. East lat Rock, North Carolina 28726 �
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Rev 7/14/Oq
Rev 2/1/IO 3,t5a�b
T1ES AREW�RK/NC',,lOqp ��� F'!N
R�pU►R�D A HO
36 DEG�STt?qpg MAYOg�►N�RNERS pFH STqBtIIZERS
V�RTt�qC qNGHp�G�EGREES�Wi-/ENIT HE�ANG E AS p�MAESE
R SOtE P(,�RP S�IS
FLORIDA ZONE II A D III LONGITUDINAL AND
LATERAL BRACING SYSTEMS PLAC.EMENT
For Roof s! es up to 4/12 pitch
Each system is required to have a fr me tie and stabilizer atta�ched at each lateral
arm sta ilizing IQcation,
Revi ed 6/17/2002
HOMEaDIMENSlO S REPRESENT BOX SlZE
��'; LEGEND L o n g i tu d i n a I �ongitudinal and Lateral Lateral Bracing �"�
Bracing Systam racing System y tem
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I� SINGLE AND DOUBLE WIOE 2 19/2 10 SINGIE AND DOUBLE WIDE
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