HomeMy WebLinkAbout94-4207
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BUILDING
BUILDING PERMIT
NP.
Permit
CiTY OF ZEPHYRHILLS
(813) 788-6611
_ 4207t
fJ-'j-11
~
v
~Lt.
ELECTRICAL
Date
PL~
...Q
V:'
MECHANICAL
Sewer connJ 1ft
t
Water Conn: rJJft
Water M~jer: N JA
N/A
Property Owner: JIMMY lAJ lLL-tr\M ~
Job Address: :-:?_~<.o I j ALpHA A\frL..
ParcelLD, # .3? -Z5~2..1-DD~A-VOOOO -/4-go
Zoning: Energy Code: ~ Radon Gas: 3,1'].
Description of Work ,q..AAt1-IO~ GDOO l\ F~\i- 27 )(./'-1)
T.I,F,'s:
NO OCCUPANCY BEFORE C.O.
FINAL
C.O.
9,;;. 6- 9
DATE
Complete Plans, Specifications and Fee Must Accompany Application,
All work shall be performed in accordarce with City Codes and Ordinances,
DATE
Valuation or
Contract Price
q, 71 /. D"D
,
Inspector
City License Registration #
State Certified License#
Signatur
Compan
Address
Telephone#
SLB
Tub Set
Water
Sewer
Final
Ii "4
f\itl16i-y 71
MECHANICAL
O(P~~
2.r,)H~Il-HILL~ fJ-fx.T. ~O
BUILDING
ELECTRICAL
Ftr. '7>-tJ.-QcffHlL Tp.Serv.
Pre SLB "l-ll NB,LL Rough In Cf-7-ttcf btll..-
Lintel Meter Can
FRM. q, 7-ytf R,u. Canst. Pole
Insul. CL Pool
WL q -if 4" BttL., Pre-Meter
W~ 6k~~ t:j-J4V bUFinal
Driveway
Breakers
Ducts Insl.
Compressor
Final
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade:
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.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
VALUATION:
SQ. FT. LIVING:
Jimmy Williams
38619 Alpha Ave.
$9,791.00
391.64
COST/FT:
$25.00
SQ. FT. OTHER:
COST/FT:
$11 .00
VALUATION
DRIVEWAY
$9,791.00
o
$20.00- · d A-J j ilYt)
"7 ll/t-OC!..i!-S~J
$20.00- \01 J+ '11/fJ. ".J_.O~!
q ~;;/9i?fr>'
ADDRESS
FEE SHEET
$65.00
SQ. FT. UNDER ROOF
391.64
RADON GAS
$3.92
TRAFFIC IMPACT FEES
99%
1 %
$0.00
$0.00
$0.00
PERMIT FEES
BUILDING:
PLUMBING:
ELECTRICAL:
MECHANICAL:
SUB-TOTAL:
CREDIT:
TOTAL:
CONNECTION FEES
SEWER:
WATER:
METER:
TOTAL:
GRAND TOTAL:
137.50
0.00
24.00
20.00
$181.50
15.00
$166.50
0.00
0.00
0.00
$0.00
$170.42 .
APPLICATION I:'OR PQHIT
CITY OF ZEPIIYlUIILLS
BUlLDING DEPARTMENT
.......
OWNER'S IWIE \. }\('t){Y'\'i C).~~\l '(' C;; .\2) \\ I \AfY\~ PHON~18L-t.ddJ~
OWNER'S ADDRESS '?J~l.o,q k~~A.~~~ /r-~~\II ~) ~ - ~9-I6
5 f-\ (V'\ ~
JOB ADDRESS
LEGAL DESCIUP'lION: LOT(S) I t./ <6 BLOCK SUBDIVISION L:: ~2..
PARCEL LD.' ?5Y~E)-JI-lYJ5A.-~--It..f~ (OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:~ew Construction ~ddition ------Alteration ____epair _Install
_Sign
---"ove
----Peaolish
pmPOSED~E: ~s~eF_i~
---"IF _' of Units ---"/B
_~ercial
_Indust. _Swia. Pool _Other
____estaurant & Health Departaent Approval
BUILDING SIZE: ~re Feet, ~ '-n Height Ck- ~br>>E.::irI'3iN~
RESIDENTIAL: ArrACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COHMERCIAL: ArrACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
-LsUILDING
../ IU.RC11UCAL
-L.,mCllAllICAL
dPL~ING
PERMITS REOUESTED
$ 6;{)t"'J0 Valuation of Total Construction
'--0
\;:) AMP Service A ~_ Florida Power Corp. W.R.E.C.
$. ZCb.ot> \D fY\~e- v~~oo1~~~i~l ~~~e>!.
GAS ROOFING SPECIALTY
TYPE OF alRSTRucnOR: -Block L~ _Steel Ju'1Y"'\\N~~cote?"<Sl'E:sv\
FIIlISHED FLOOR ELEVAnORS:~. IS PROJEct IN FLOOD ZORE AREA? 1
YES NO
..........................................
CORTRActOR SEctION'
BUTlJlER COKPANY
~:Jb.} ~ State Cert. or Regist. .
Signature ' ~~ \ City License Registration .
) ..........................................
~ COHPARY Z--t-\,,-,,,, ~'--"c, - <;:V,-,
.. r '.. V State Cert. or Regist. . out), ^ Lt.. ~
ur City License Registration' r D
. ........................................
PLUMBER
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
COMPANY ;I(;-/>l ~- -('.'.,", C~v I~,<,~f /
State Cert. or Regun. . 0'r'/ _co-tv u:<..
/"L--,.-... City License Registration . 7 (
..........................................
Signature
~
IlEClWUCAL
./
,/....
Signature&:/ .,
OTRRR COMPANY
State Cert. or Regist. .
Signature City License Registration .
..........................................
APPLIc.\nOK APP1IOVIlD BY t< l~ 4- g, '1/^ PERllIT OPl'ICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS'
Tbe undersigned understands that this pemit Jay be subject to 'deed restrictions' wbieb Jay be lOre restrictive than City
regulations. !he undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner bas bired a contractor or contractors to undertake wort, they .ay be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the OIfDer and contractor JaY be
cited for a .isdelll!anor violation under state law. If the owner or intended contractor are' uncertain as to wllat licensing
requir8lellts JaY apply for the intended work, they are advised to contact the City of Zepbyrhills Building Departlent, (813)
788-6611.
FurtberlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
"Contractor Sections' of this application for wbicb they will be responsible. If you, as the owner sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
as contractor that JaY be an indication that be is not properly licensed and Is not entitled to peraitting privileges in the
City of Zepbyrbills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, IIave been provided with a copy of 'Florida's construction Lien Law - lbIeoImer's Protection
Guide" prepared by the Florida DepartJent of Agriculture and ConsUJeI Affairs. If the applicant is 8OIeODe other than the
'owner", I certify that I IIave obtained a copy of the above described dOCUleDt and proaise in good faith to deliver it to the
"owner' prior to COlleDc8lent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the inforaation in this application is accurate and that all work "ill be done in cOlpliance with all
applicable laws regulating construction, loning, and land developent.
Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no IfOrk or
installation bas ~ced prior to issuance of a penit and that alllfOrk "ill be perfotled to leet standards of all 1_
regulating construction, City codes, loning regulations, and land developent regulations in the jurisdiction. I also
certify that I understand that the regulations of other 90veIDJeDtal agencies JaY apply to the intended IfOrk, and that it is
., responsibility to identify wbat actions I lUSt tate to be in COIpliance. Sueb agencies include but are not liJited to:
I Departlent of EnviIODJelltal Regulation - Cypress Baybeads, Wetland Areas and RnviroDJentally Sensitive Lands,
Water/Wastewater Treatlent
t Southwest Florida Water Hanagl!lf!llt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t Amy Corps of Engineers - Seawalls, Docks, Navigable Waterways
I Departlent of Health , Rehabilitative Services, EnvirODJeDtal Health Unit - Wells, Wastewater Treatlent, Septic Tants
t US EnvirODJeDtal Protection Agency - Asbestos abatl!lellt
I also certify that, if fill .aterial is to be used in Flood ZOne "A' or 'A,etc.', it is understood that a drainage plan
addressing a 'cOJpeDsating volute' will be subtitted wbieb is prepared by a professional engineer registered in the State of
Florida prior to pemit issuance.
A perlit issued sball 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 sball issuance of a penit prevent the Building Official frOl thereafter
requiring a 'correction of errors in plans, construction, or violations of any code. Every pertlt issued shall becoIe invalid
unless the work authorized by sueb perlit is COlll!llced within sil IODthS of issuance, or if work autboriled by the penit is
suspended or abandoned for a period of sil IOnths after the tile the work is ~ced. One 90 day atension of tile, JaY be
allowed for the pemit with fee cbarge of $15.00. Tbe extension sllall be requested in writing to the Builting Official. An
approved inspection lUSt be logged during eaeb sil IOnth period, or the project will be considered abandoned.
WARNING TO OIIIIR: YOUR FAILURI TO RlCORD A IOTICK OF C(JIMIIfClllBIfI MAY RlSULT II YOUR PAYIIIG DICK FOR lIIPROVIIIIIfS TO YOUR
PROPERTY. IF YOU IIl'l'DD TO OBTlllf FlIfMCIIG, CONSULT WITH YOUR LBJIDIR OR 111 AnORDY BBlORB RBCORDIIfG YOUR IO'l'ICB OF
C(lDfENCKMBIfI. JOBS URDU $2,500 IIf VALUE DO NOT NEED TO RECORD AID POST A "NOTICE OF C(JIIEIfCBMElf'l".
~~~
SIGIfArURB: COJrRACTOR
SrArl OF FLORI~
coum OF . f'-C '"
The foregoing 1n~~ent was ~~owledged
before me this ~, 19::t4- by
srArl OF FLORIDA
coum OF
The foregoing instrument was acknowledged
before me this , 19_____ by
who is personally known to me or who has
roduced
as identification and who did/did not
take an oath.
(Signature)
,r.
"
(Name yped,' rinted or Stamped)
NOTARY PUBLIC ",t~~';~tz'", '''~. SAM W. SURRA". '-.
[*"( A\,O.~ rvrt COMMISS[O~11l CC339113, EXPIAm
W.~.'~<' January 17. 1998
'<f;;~,~;~;'" BONDED THRU TROY F~,IN INSURANCE, lNa.
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
" ':.,!,'" ~.
. FLORIDA ENERGY EFFICIENCY CObE FOR BUILDING CONSTRUCTION
FORM 600C-93 Residential Limited Applications Prescriptive Method C CENTRAL 4 5 6
Small Additions and Renovations Department of Community Affairs
Compliance with Method C of Chapter 6 of the Florida Energy Efficiency Code may be demonstrated by the use of Form 600C-93 for additions of 600 square feet or less, site- installed components
of manufactured homes, and renovations to single and multifamily residences. Alternative methods are provided for additions by use of Form 600B-93 or 600A-93.
PROJECT NAME: JIMMY WILLIAMS FAMILY BUILDER: OWNER
AND ADDRESS: 38619 ALPHA AVENUE PERMITTING CLIMATE 405060
ZEPHYRHILLS FL 33540 OFFICE: ZONE:
OWNER: JIMMY O. WILLIAMS JR PERMIT NO.ITIICLII] JURISDICTION NO.: rrrr=IIJ
SMAll ADDITIONS TO EXISTING RESIDENCES (600 Square feet or less of conditioned area). Prescriptive requirements in Tables 13C-1, 6C-2 and 6C-3 apply only to the
components of the addition, not to the existing building. Space heating, cooling, and water heating equipment efficiency levels must be' met only when equipment is installed
specifically to serve the addition or is being installed in conjunction with the addition construction. Components separating unconditioned spaces from conditioned spaces must
meet the prescribed minimum insulation levels. RENOVATIONS (Residential buildings undergoing renovations costing more than 30% of the assessed value of the building).
Prescriptive requirements in Tables 6C-1 and 6C-2 apply only to the components and equipment being renovated or replaced. MANUFACTURED HOMES AND BUilDINGS. Only site-
installed components and features are covered by this form. Please Print CK
1. Renovation, Addition or Manufactured Home
2. Single family detached or Multifamily attached
3. If Multifamily-No. of units covered by this submission
4. Conditioned floor area (sq. ft.)
5. Predominant eave overhang (ft.)
6. Porch overhang length (ft.)
7. Glass area and type:
a. Clear glass
b. Tint, film or solar screen
8. Percentage of glass to floor area
9. Floor type and insulation:
a. Slab on grade (R-value)
b. Wood, raised (R-value)
c. Wood, common (R-value)
d. Concrete, raised (R-value)
e. Concrete, common (R-value)
10. Wall type and insulation:
a. Exterior:
1. Masonry (Insulation R-value)
2. Wood frame (Insulation R-value)
b. Adjacent:
1. Masonry (Insulation R-value)
2. Wood frame (Insulation R-value)
c. Marriage Walls of Multiple Units* (Yes/No)
11. Ceiling type and insulation:
a. Under attic (Insulation R-value)
b. Single assembly (Insulation R-value)
12. Cooling system*
(Types: central, room unit, package terminal A.C., none)
13. Heating system*:
(Types: heat pump, elec. strip, natural gas, LP. gas, room or PTAC, none)
14. Air Distribution System*:
a. Backflow damper or single package systems* (Yes/No)
b. Ducts on marriage walls adequately sealed* (Yes/No)
15. Hot water system:
(Types: elec., natural gas, other, none)
. Pertains to manufactured homes with site installed components.
I hereby certify that the plans and specifications covered by the calculation are in
compliance with the Florida Energy Code.
PREPARED BY: DATE:
I hereby certify that this building is in compliance with the Florida Energy Code.
OWNER AGENT: DATE:
1. ADDITION
2. SINGLE FAMILY Jl.TTACHED
3. N/A
4. 378 SQ FEET
5. 1'-0"
6. N/A
Single Pane Double Pane
7a. N/A sq. ft. N/A sq. ft.
7b. 32 sq. ft. N/A sq. ft.
8. 8 0/0
9a. R= 0 378 sq. ft.
9b. R= N/A N/A sq. ft.
9c. R= N/A N/A sq. ft.
9d. R= N/A N/A sq. ft.
ge. R= N/A N/A sq. ft.
10a-1 R= N/A N/A sq. ft.
10a-2 R= 19 287 sq. ft.
1 Ob-1 R- 5 160 sq. ft.
10b-2 R= N/A N/A sq. ft.
10c N/A - N/A
11a. R= N/A N/A sq. ft.
11b. R= 14 37.~ sq. ft.
12. Type: WALL MOUNTED ROOM UN
SEERlEER: 9
13. Type: SAME AS COOLING
HSPF/COPJAFUE:
14a. N/A
14b. N/A
15. Type: N/A
EF: N/A
T
Review of plans and specifications covered by this calculation indicates compliance
With the FlOrida Energy Code. Before construction is completed, this building will be
Inspected for compliance in accordance with Section 553.908, F.S.
BUILDING OFFICIAL:
DATE:
-1-
Climate Zones 4 5 6
TABLE 6C.1 : PRESCRIPTIVE REQUIREMENTS FOR SMALL ADDITIONS (600 Sq, Fl and less), RENOVATIONS TO EXISTING BUILDINGS AND SITE-INSTALLED COMPONENTS OF MANUFA~TURED HOMES~'
MINIMUM INSULATION
COMPONENT INSULATION INSTALLED
Concrete R-5
(/) Frame, 2' x 4' R-11
...J Frame, 2' x 6' R-19
...J
<( Common, Frame R-11
3:
Common, Masonry R-3
~ Under Attic R-30
z Single Assembly; enclosed R-19
:J
W Single Assembly; Opened R-10
U Common, Frame R-11
(/) Slab-on-grade No Minimum
a: Raised Wood R-11
0
0 Raised Concrete R-5
...J
U. Common, Frame R-11
f-
U In unconditioned space R-6
::::>
Cl In conditioned space No minimum
MINIMUM INSTALLED
EQUIPMENT EFFICIENCY EFFICIENCY
C!l Central NC - Split SEER = 10.0 SEER = -
z
:::i -Single Pkg. SEER = 9.7 SEER =
0 -
0 Room unit or PTAC EER = 8.5" EER =
u -
Electric Resistance ANY
C!l Heat pump - Split HSPF = 6.8 HSPF =
z -
i= - Single Pkg. HSPF = 6.6 HSPF =
<( -
W
:I: Room unit or PTHP COP = 2.7" HSPFI =
W -
u COP
<(
0... Gas, natural or propane
en AFUE = .78 AFUE =
-
Fuel Oil AFUE = .78 AFUE = -
cr: Electric Resistance EF = .88 EF
f-W = -
o!;;: Gas; Natural or LP. EF .54 EF
:1:3: = = -
Fuel Oil EF = .54 EF =
TABLE 6C-2: PRESCRIPTIVE REQUIREMENTS FOR GLASS AREAS IN ADDITIONS ONLY
. See Table 6-3, 6-7
Maximum percentage glass to floor area allowed is selected by type, overhang length, and shading coefficient. Maximum%- Installed %-
GLASS TYPE, OVERHANG, AND SHADING COEFFICIENT REQUIRED FOR GLASS PERCENTAGE ALLOWED
UP TO 20% UP TO 30% UP TO 40% UP TO 50%
Single Double Single Double Single Double Single Double
OH-SC OH-SC OH-SC OH-SC OH-SC OH - SC OH-SC OH-SC
1'- 1.0 0'- .90 2'-1.0 1'- .90 3'- 1.0 2'- .90 4'- 1.0 3'- .90
0'- .86 1'- .86 0'- .70 2'- .86 1'- .70 3'- .86 2'- .70
0'- .65 1'- .65 0'- .50 2'- .65 1'- .50
0'- .45 1'- .45 0'- .40
0'- .35
Shading coefficients (SC) may be obtained from the manufacturer. Single clear SC = 1.0, double clear SC = .90, and single tint SC = .86.
TABLE 6C-3 I MINIMUM REQUIREMENTS FOR ALL PACKAGES
COMPONENTS SECTION REQUIREMENTS CHECK
Exterior Joints & Cracks 606.1 To be caulked, gasketed, weather-stripped or otherwise sealed.
Interior Joints & Cracks 606.1 All openings in interior surfaces of ceilings and exterior walls must be sealed.
Sole & Top Plates 606.1 Sole plates and penetrations through top plates of exterior walls must be sealed.
Infiltration Barrier 606.1 Infiltration barrier must be installed in exterior walls & raised wood floors.
Fireplaces 606.1 Fireplaces must have flue dampers, glass doors and outside combustion air intakes.
Exhaust Fans 606.1 Exhaust fans vented to unconditioned space shall have dampers, except for combustion
devices with integral exhaust ductwork.
Combustion 606.1 Combustion space and water heating systems must be provided with outside combustion air,
Heating except for direct vent appliances.
Water Heaters 612.1 Comply with efficiency requirements in Table 6-11. Switch or clearly marked circuit breaker (electric)
or cutoff (gas) must be provided. External or built-in heat trap required_
Swimming 612.1 Spas & heated pools must have covers (except solar heated). Non-commercial pools must have a
Pools & Spas pump timer. Gas spa & pool heaters must have minimum thermal efficiency of 78%.
Hot Water Pipes 612.1 Insulation is required for hot water circulating systems, (including heat recovery units) and the first
8' of piping from the water heater (or until piping enters an insulated wall or slab).
Shower Heads 612.1 Water flow must be restricted to no more than 3 gallons per minute at 80 PSIG.
HV AC Duct 610.1 All ducts, fittings, mechanical equipment and plenum chambers shall be mechanically attached,
Construction, sealed, insulated and installed in accordance with the criteria of Section 610.1. Ducts in attics must be
Insulation & Installation insulated to a minimum of R-6. Air handlers shall not be installed in attics unless in mechanical closets.
HV AC Controls 607.1 Separate readily accessible manual or automatic thermostat for each system.
GENERAL DIRECTIONS:
1. On Table 6C-1 indicate the R,value of the insulation being added to each component and the efficiency levels ofthe equipment being installed. All R-values and efficiencies installed must meet or exceed the minimum values
listed. Components and equipment neither being added nor renovated may be left blank.
2. ADDITIONS ONLY. Determine the percentage of new glass to conditioned floor area in the addition as follows. Total the areas of all glass windows, sliding glass doors and glass door panels. Double the area of all non-
vertical roof glass and add it to the previous total. When glass in existing exterior walls is being removed or enclosed by the addition, an amount equal to the total area of this glass may be subtracted from the total glass area.
Divide the adjusted glass area total by the conditioned floor area of the addition. Multiply by 100 to get the percent. Find the largest glass percentage under which your calculated percentage falls on Table 6C-2. Prescriptives
are given by the type of glass (Single or Double pane) and the overhang (OH) paired with a shading coefficient (SC). For a given glass type and overhang, the minimum shading coefficient allowed is specified. Actual glass
windows and doors previously in the exterior walls of the house and being reinstalled in the addition, do not have to comply with the overhang and shading coefficient requirements on Table 6C-2. All new glass in the addition
must meet the requirement for one of the options in the glass percentage category you indicated. The overhang (OH) distance is measured perpendicularly from the face of the glass to a point directly under the outermost edge
of the overhang.
3. RENOVATIONS ONLY. Replacement glass needs to meet the fOllowing requirements. Any glass type and shading coefficient may be used for glass areas which are under at least a two foot overhang and whose lowest
edge does not extend further than 8 feet from the overhang. Glass areas being renovated that do not meet this criteria must be either single-pane tinted, double-pane clear or double-pane tinted.
4. Complete the information requested on the top half of page 1.
5. Read "Minimum Requirements for Small Additions and Renovations", Table 6C-3, and check all applicable items.
6. Read, sign and date the "Owner/Agenr certification statement on page 1.
-2-
<<
STATIO' 'LOAIDA
City of Zephyrhills
I
: PASCO COUNTY
DISBURSEMENT REQUEST. REFUNDS & MISCELLANEOUS PAYMENTS
.g .- 5-7//
9ATE
"
TO: ACCOUNTING
FROM:
. .-1 ,A/ . O-R-
AMOUNT: . ' r{)..
. ('. 2 €J rV
PAYABLETO: . C7..-A'a ~ A~I~
~R {, 19 a{taIJfl.- il~ ~
tJ .
o // /),1 :3 r, /- L//J
c.5 ....!2.A.Yf~ $":;> LV
VENDOR .:
REASONFORPAYMENT:@~~A'~r:-~ a<L~J V~7f 'ItltJ14
L.55U.L<l-t R'- f-71. ()
CHARGE TO ACCOUNT' 01- (""3:<~ - 000
REQUESTEDBY:I:.I!S~
4, \. . .---j8ID>>~tU~')
. . APPROVED BY: /~
(Signature)
ACCOUNTING USE ONLY:
Paid Date:
check .
Lots
Block
Footage
Receipt N~ 8 0 3 6 8
19 7 'l"
Rate Amount Due /70
jl~ # l/.;zOf!.f3 /37.:)0
E -:;-. [I ~ VO
IrJ ~" -Vz:/
~ {Ie VSdCJ?
j?/JW/v 3p 7:2
.
City of Zephyrhills
5335 Eighth Street. Zephyrhills, Florida 33540 c::.[/
(813) 788-2313 Date l5 - 1:
(
Street No.
tv.' / l ' /'J-n-t S
( ) Other
Name
NOTICE: All assessmen $170. 42c 4
date and will bear interest at
send postage for return receipt
~, \.