HomeMy WebLinkAbout05-4733
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
4733
Permit #:4733 Issued: 2/27/2006
Permit Type: NEW SINGLE FAMILY DWELLING
Class of Work: 101-NEW CONST/SFR
Proposed Use: SINGLE FAMILY RESIDENTIAL
Sq. Feet: Est. Value:
Cost: 130,500.00 Total Fees: 8,603.98
Amount Paid: 8,603.98 Date Paid: 2/27/2006
Address: 7619 MERCHANTVILL
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: CRESTVIEW HILLS
Parcel Number: 35-25-21-0120-00000-0140
Name: LENNAR HOME INC
Addr: 600 N WESTSHORE BLVD. STE 900
TAMPA,FL. 33609
Phone: Lie: Phone:
Work Desc: NEW SFD-REPERMITTED DUE TO EXPIRATION OF ORIGINAL ON 1/16/06
Name: LENNAR H INC
Address: 7619 MERCHANTVILLE CIR
ZEPHYRHILLS, FL. 33542
WATER CONNECTION RESIDENl
SCHOOL IMPACT FEE - 97.5%
WATER METER RES 3/4"
POLICE IMPACT FEE
RADON
PLUMBING FEE
419.00 MECHANICAL FEE
1,651.65 TRAFFIC IMPACT FEE 1%
180.00 BUILDING FEE
254.00 PARK FEES SF
23.74 BUILDING FEE
55.00 MECHANICAL FEE
ELE
80.65 SCHOOL IMPACT FEE 2.5%
15.88 TRAFFIC IMPACT FEE 99%
865.50 FIRE IMPACT FEE
769.56 PUBLIC SAFETY 5%
432.75 ELECTRICAL FEE
40.33
42.35
1,572.12
273.00
26.35
58.70
lftcY .
/ 00- (//rJ-I
Y' \ n,\'b.-{.Y'
DUCTS INSTALLED PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB
DUCTS INSULATED LINTEL PRE-METER WATER
SHEATHING FRAME MISC SEWER
MISC INSULATION WALL MISC MISC.
MISC. INSULATION CEILING MISC. MISC.
MISC. DRIVEWAY MISC. MISC.
REINSPECTlON FEES: Reinspection fees will comply with Florida Statute 553.80 (2)( c) when extra inspection
trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections called d) work not ready for
inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
IIWarning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your prope~ If you intend to obtain financing, consult with your lender or an attorney
before recordin r notice commencement. II
~.
SI NAT E PERMIT OFFI
LL FOR INSPECTION - 8 HOUR NOnCE REQUIRED . ~
ROTECT CARD FROM WEATHER
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CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT SINGLE FAMILY RESIDENTIAL
4733
Permlt umber: 4733 Issued: 7/20/2005
Permit Type: NEW SINGLE FAMILY DWELLING
Class of Work: 101-NEW CONST/SFR
Proposed Use: SINGLE FAMILY RESIDENTIAL
Sq. Feet: Est. Value:
Cost: 130,500.00 Total Fees: 8,017.20
Amount Paid: 8,017.20 Date Paid: 7/20/2005
Name: LENNAR HOM S INC
Addr: 600 N WESTSHORE BLVD. STE 900
TAMPA,FL. 33609
Phone: Lie:
Work Desc: NEW SINGLE FAMILY DWELLING
Address: 7619 MERCHANTVILLE CIR
ZEPHYRHILLS, FL.
Township: Range:
Lot(s): Block: Section:
Book: Page:
Subdivision: CRESTVIEW HILLS
Parcel Number: 35-25-21-0120-00000-0140
LENNAR HOME INC
7619 MERCHANTVILLE CIR
ZEPHYRHILLS, FL. 33542
Phone:
E
WATER CONNECTION RESIDENl
SCHOOL IMPACT FEE - 97.5%
WATER METER RES 3/4"
POLICE IMPACT FEE
RADON
419.00 MECHANICAL FEE
1,651.65 TRAFFIC IMPACT FEE 1%
180.00 BUILDING FEE
254.00 PARK FEES SF
23.74
80.65 SCHOOL IMPACT FEE 2.5%
15.88 TRAFFIC IMPACT FEE 99%
865.50 FIRE IMPACT FEE
769.56 PUBLIC SAFETY 5%
42.35
1,572.12
273.00
26.35
FO 11M
DUCTS INSTALLED PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB
DUCTS INSULATED LINTEL PRE-METER WATER
SHEATHING FRAME MISC SEWER
MISC INSULATION WALL MISC MISC.
MISC. INSULATION CEILING MISC. MISC.
MISC. DRIVEWAY MISC. MISC.
REINSPEcnON FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Thirty-Five Dollars ($35.00) 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
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements our property. If you intend to obtain financing, consult with your lender or an attorney
before notice of commencement."
NO OCCUPANCY BEFORE C.O.
CONTRACTORS SIGNATURE PERM.
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
DATE RECEIVED
PHONE CONTACT FOR PERMITTING
Lu,()ar 1f:;1tI~, LM6
JOB ADDRESS~P(du:u1f-~II/.e Clr~e.
PHONE 813 - gg2 - .tf&63 j13
OWNER'S NAME
LEGAL DESCRIPTION: LOT(S) ~ BLOCK
PARCEL 10 # 3S..Q7'51061f"O\;u)1'YtiX)-()140
-
SUBDIVISION W..l-l--viuAJ
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPSED: ~NEW CONSTRUCTION
o ADDITION
DALTERATION
o REPAIR
o INSTALL
DSIGN
o MOVE
o DEMOLISH
PROPOSED USE: ~SGL FAMILY DWELLING
o COMMERCIAL
DMULTI-FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
o MOBILE HOME
o OTHER
BUILDING SIZE
CJ
0~OS&
t,fd X' ~O' :2.. If
RESTAURANT & HEALTH DEPARTMENT APPROVAL
UczP1U~, wJ/)<f~
SQUARE FO TAGE d 31 tf
HEIGHT
DESCRIPTION OF WORK
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
o BUILDING
$
J~O/S-OD.~
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o Progress Energy 0
W.R.E.C.
o PLUMBING
o MECHANICAL
$
J 1 (j)().~
~\
o SPECIALTY
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o OTHER
TYPE OF CONSTRUCTION: if BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS ~
IS PROJECT IN FLOOD ZONE AREAD YES 0 NO
SIGNATURE
STATE CERT OR REGIST #
:5
Ci3c 01 &&9j
BUILDER
COMPANY
*******************************************************
SIGNATURE
~,
J)t14<d1
COMPANY &J /Y1fJA ~
STATE CERT OR REGIST # 00/3/3 'f
ELECTRICIAN
******************************************************************
SIGNATURE
~~
******************************************~*****~************
~ lJ . COMPANY. ~ '\ 'l1)jAlJ(j~
/" L ()L ){lLjcfU STATE CERT OR REGIST # ci4CDS/J 4/0
NJtuy:rb
COMPANY ~+ ,
STATE CERT OR REGIST # CFGOL/J. 99 f
PLUMBER
SIGNATURE
MECHANICAL
SIGNATURE
H' .:;;........~............~.. ~~~::;:. (i"~' ;:;. H~
~ ;JJIIPt/~ STATE CERT OR REGIST # IlC.l-l~-()/3
OTHER
A. NOTICE OF DEED RESTRICTIONS
The undersigned understands that this permit may be subject to "deed restrictions" which
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. 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
City of Zephyrhills Building Department, 813-780-0020.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s) sign portions of the "Contractor Sections" of this application for which they
will be responsible. If you, as the owner signs 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 may be an indica~ion that he is not properly licensed and is
not entitled to permitting privileges in the City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, have been provided with a copy of "Florida's Construction
lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owner", I cerify 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.
E. 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, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to identify what actions I must take to
be in compliance. Such agencies include but are not limited to: *Department of
Environmental Regulation-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-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone "A" or "A, etc.", it is
understood that a drainage plan addressing a "compensating volume" will be submitted which
is prepared by a professional engineer registered in the State of Florida prior to permit
issuance.
A permit issued shall 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 code. Every permit
issued shall become invalid unless the work authorized by such permit is commenced within
six months of issuance, or if work authorized by the permit is suspended or abandoned for 'a
period of six months after the time the work is commenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to the Building Official. An approved inspection must be logged during each six
month period, or the project will be 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
$2,500 IN VALUE D TO RECORD AND POST A "NOTICE OF COMME
SIGNATURE: OW
SIGNATURE:
STATE OF FLORIDA~L{Jl)Jb ~
COUNTY OF.... UlD
The foregoing instrument was ack owledged ~
Before me t. hi~. .. day of it (I ~ ' 20-'L
by ~ 11 S a/v
/ (name of person acknowledged9
~who is personally known to me, or
STATE OF FLORIDA II ,J)... J /h../.
COUNTY OF c:::A/LI.J<..'YA1I::nu~,-
The foregoing inst~ument was~ac!inowledged __
~~fore me thi~aY5''li.~:f~ ,2Dcl
~ (name of person acknowle ed)
~ho is personally known to me, or
Owho has produced
(type
Odid not
./
Owho has produced
(type of identification)
and who OEd not
j
Name
Name typed, printed or stamped
~..",.y ~ Kimberly Kay Daugette
. ~ ; My Commission 00026612
'\:...~,l' Expires September 10, 2005
PLOT. PLAN
LOT 14
CRESTVIEW HILLS
PASCO COUNTY, FLORIDA.
PRELIMINARY DRAWING:
THIS PLAN IS FOR PERMITTING PURPOSES
ONLY. NOT FOR CONSTRUCTION. VERIFY
ALL DIMENSIONS BEFORE ANY CONSTRUCTION.
SKETCH ONLY
NOT A BOUNDARY SURVEY
SEC. 35
, TWP. 25 S, RNG.
21 E.
BEARING BASIS:
NORTHERLY LOT UNE OF LOT 14 BEING N 89"36'03" E
N
THIS SURVEY IS SUBJECT TO ANY FACTS THAT
MAY BE DISCLOSED BY A FULL AND ACCURATE
TITLE SEARCH. ALSO SUBJECT TO SETBACKS,
EASEMENTS AND RESTRICTIONS OF RECORD.
LEGEND:
------ = PROPOSED DRAINAGE FLOW
(00.00) = PROPOSED GRADE
E-OO.OO = EXISTING GRADE
b
".,
UNDERGROUND FOOTER, STEM WALL. AND
UNDERGROUND UTILITIES ARE NOT LOCATED OR
SHOWN.
~
W
...J
<<:
u
1Il.
DO NOT SCALE THIS PRINT. DIMENSIONS AND
NOTES TAKE PREFERENCE.
DESCRIPTION NOT CONTAINING PLAT BOOK AND
PAGE INDICATES THAT PLAT IS IN
PRELIMINARY STAGE AND IS SUBJECT TO
CHANGE AND/OR REVISION.
CERTAIN DATA SHOWN HEREON BASED ON
ENGINEERING PLANS PROVIDED BY CLIENT.
>-
rr
....<i
<iO
...JZ
Cl.::>
~ g 0<-
Q.;> "s.
0$) 0)
LOT 15
. = 10' DRAINAGE & UTIUTY EASEMENT
.. = 5' DRAINAGE EASEMENT
... = 10' DRAINAGE EASEMENT
"6
0
0 0
<( to
0 :s:
0:::
to
W '<t
'<t
0::: 0
b
3: 0
z
b' **
.... .G1:2.2'=..~~:- - - - - - - - - -
60' 2"
b:
o~_ _
~ : 20.50'
l~ w
....J
25.00' 0
0:::
0
0 IW
~o
~" ....J
....J~
W" 0 -~
f:::~
f>..
l{) Ze
I"') <(
N J:
b
0 10
~ 0:::
W
::;E
-------
17,,6' 17".s>
N 89"36'03" E 111.82' _______ '0$0) '''7)'
*
*
*
I
b 1.
I Z.1- ."~.
I ju::c .- I" "
\ /.... D..' !!!
: J ~ Ui'rso
O&1~ I
I ~ f-Cl
I <i I *
31.44'
'[=='~'~~ - - -;;- - - _ _ _~_ _ J
~. ~'06' 06'
~. ~.
~'j; ~'j;
TRACT "F"
LANDSCAPE
BUFFER
------
S 89.36'03" W
112.15'
-----., .,
'00 ,'b
~. q,.
~'j; ~'j;
"~
LOT 13
t
PC(P).-J
PROPOSED
LOWEST FLOOR ELEVATIONS:
LIVING AREA: 127.50'
GARAGE AREA:
ELEVATIONS REFERENCED TO
NA TIONAL GEODETIC VERTICAL
DATUM OF 1929. MEAN SEA
LEVEL= 00.00 FT.
DESCRIPTION:
LOT 14 MAP OR PLAT ENTITLED "CRESTVIEW HILLS", AS
RECORDED IN PLAT BOOK ___, PAGES ___ THROUGH
OF THE PUBLIC RECORDS OF PASCO COUNTY, FLORIDA.
NOTES:
LOT GRADING TYPE = C
PROPOSED PAD ELEVATION = 127.00'
FRONT SET BACK = 20'
SIDE SET BACK = 7.5'
REAR SETBACK = 15'
LOT =~719.4fL_so. FT.
UVlNG AREA =-11!.~_SO. FT.
ENlRY =~_SO. FT.
GARAGE = ----.J~L__so. FT.
COVERED LANAI =_ 9~_SO. FT.
PATIO =-11 A _SO. FT.
POOL AREA =_N A _SO. FT.
CONC. DRIVE =__~SO. FT.
A/C & CONC PAD =_~__SO. FT.
SIDEWALK - 31 SO. FT.
SIDE YARD SWALE =_ 11J5 _SO. FT.
CONSER VA TlON AREA = N A __SO. FT.
LOT OCCUPIED =_~
AREA TO IRRAGA TE = ~L-J:
APPARENT FLOOD HAZARD ZONE: ''X'' COMMUNITY PANEL NO. 120230 0295 D EFFECTIVE DATE: 9/30/92
LEGEND:
(C)= CALCULATED DATA. (0)= DEED DATA. (M)= MEASURED DATA. (P)= PLAT DATA. {= CENTERLINE, A/C= AIR CONDITIONER, B/C= BACK OF CURB. C/S=
CONCRETE SLAB. CH= CHORD. CHB= CHORD BEARING. CLF. CHAIN LINK FENCE. CONC= CONCRETE. COV.. COVERED. E/P. EDGE OF PAVEMENT. ESM'T= EASEMENT.
F/C= FENCE CORNER, FCM= FOUND CONCRETE MONUMENT. FIP= FOUND IRON PIPE. FIR= FOUND IRON ROD. FN&D= FOUND NAIL & DISK. FPP. FOUND PINCHED
PIPE, LFE= LOWEST FLOOR ELEVATION. MAS.. MASONRY. OR= OFFICIAL RECORD BOOK. PB= PLAT BOOK, PCP= PERMANENT CONTROL POINT. PRM- PERMANENT
REFERENCE MONUMENT. R/W= RIGHT OF WAY. R= RADIUS, SIR.SET 1/2" IRON ROD & CAP No. 4493. SNaO= SET NAIL & DISK. TBM= TEMPORARY BENCHMARK.
U/P= UTILITY POLE. W/F= WOOD FENCE. (R) = RADIAL
O!~
WAY I (
JOHN R. BEACH Be ASSOCIATES, INC.
SURVEYORS AND MAPPERS
911 WEST ST. PETERSBURG DRIVE
OLDSMAR. FLORIDA 34677
(813) 854-1276 FAX (813) 855-8370
Drawn By.
SMS
Square Feet;
6719.46 :!:
LENNAR
Checked By.
Scale:
NOT VALID WITHOUT THE SIGNATURE AND Date: PLOT PLAN 4/6/05 BB
THE ORIGINAL RAISED SEAL OF A FLORIDA
LICENSED SURVEYOR AND MAPPER
Revisions:
Lennar Homes
7619 Merchantville Cir.
SQ. FEET PRICE
MAIN OR LIVING: 2,374 $ 50.00
OTHER AREA UNDER ROOF: $ 50.00
OTHER: $ -
VALUATION $ 118,700.00
FEE SHEET $ 537.00
ADDRESS $ 30.00
DRIVEWAY $ 30.00
BUILDING: $ 865.50
CREDIT: $ -
BUILDING LESS CREDIT: $ 865.50
ELECTRICAL: $ 117.40
PLUMBING: $ 110.00
MECHANICAL: $ 80.65
SUB-TOTAL $ 1,173.55
RADON: $ 23.74
TOTAL $ 1,197.29
SEWER: $ 1,616.00
WATER: $ 419.00
IRRIGATION: $ -
TOTAL: $ 2,035.00
WATER METER:I $
IRRIGATION METER $
180~00 I
SUB-TOTAL $
3,412.29 ,
769.561
PARK IMPACT FEESI $
PUBLIC SAFETY IMPACT FEES
POLICE $ 254.00
FIRE $ 273.00
5% $ 26.35
SIF'S: $ 1,694.00
97.5% $ 1,651.65
2.5% $ 42.35
TI F'S: $ 1,588.00
99% $ 1,572.12
1% $ 15.88
TOTAL: $
8,017.20 ,
11111111111111111111111111/ II1111I1111II11111111111111111111
2005136527
Pennit No.
Rcpt:900819
os: 0. 00
07/07/05
Rec: 10.00
IT: 0. 00
Dpty Clerk
NOTICE OF COMMENCEMENT
For the County of Pasco in the State of Florida
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following infonnation
is provided in this Notice of Commencement:
1. Description of Property: Parcel No.35/25/21/0/;~O!c()00D/OIL/D
SEC:35 ,TWP:25 ,RGE:21/Block:";: Lot: 1'1 Crestview Hills as recorded in Plat
Book 53 ,Page 124 of the Public Records of Pasco County.
(Legal Description of property and street address if available)
2. General Description of Improvement: Single Family Residence Dwelling Unit
3. Owner Information: Lennar Homes, Inc.
Address: 600 N. Westshore Blvd, Suite #900 City: Tampa State: FL Zip: 33609
Interest in Property: Fee Simple
Name of Fee Simple Titleholder: Same
4. Contractor: Name Lennar Homes, Inc.
Address: 600 N . West shore Blvd Suite #900 City: Tampa State: FL Zip: 33609:
5. Surety: Name N/A
Address: N/A
Amount of Bond: N/ A
6. Lender: Name N/ A
Address: N/ A
7. Persons within the state of Florida designated by Owner upon notices of other
documents may be served as provided by Section 713.13(1) (a) (7), Florida
Statues:
Name: Michael F. Southward
Address: 600 N. Westshore Blvd. Suite #900 City: Tampa State: FL Zip: 33609
8. In addition to himself, Owner designates
of
to receive a copy of the Lienor's Notice as provided
in Section 713.13 (1) (b), FIOlida Statues.
9.
Expiration date of No~ice Of. com. ~e~Jbent: (~he ex~iration date is 1 year
from the date ofrecordmg ~pl~a dIf lint date IS specIfied.)
~ C()/ v' 1/
Signature of Owner: / ",' ...~
Sworn to and subscribed befor: me th}s d- day of CJlt~ , 2005
Notary Puhlic; ~~ ;JJtU(~y Commission Expires:
l~,,"1 '''~<_ i<imberly I<.ay naugetle
: ~I. '; M. Y (.~ommis~ion 000.. 2661,"
,..'.~~. ~
-:\;-C'i ,\'_~t~ r;Xpl!"(~S Si?ptc;nber t {}, 200ft
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PERFORMANCE BUSINESS PRODUCTS. INC. 813-719-8008 FAX 813-719-7919
CITY OF ZEPHYRHILLS
ZEPHYRHILLS, FLORIDA
s: ~8o
WATER ACCT. NO.
7~h5
{ .
DATE
OWNER/
RENTER
kPVY' ~
.
~~-
MAILING
SERVICE ADDRESS 711?
SHUT OFF SERVICE 0
TURN ON SERVICE ~
INSTALL METER ~
READ METER 0
CHECK METER 0
OTHER 0
/J1~/k C/~.
~TER
~~~
o SEWER
o GARBAGE
~ITY
o OUT CITY
--I-- No. OF UNITS
_ DEPOSIT AMOUNT
, (
- AMOUNT lAST BILL
% II u:1Jr~
_DATE
_ MISC. CHARGE
WORK COMPLETED BY
& DATE COMPLETED
ORDER TAKEN BY
u-
Retain white form in office at all times.
Send pink & yellow forms to Water Service Dept.
Water Service Dept. to sign yellow form & return to office.
04/25/2005 10:17
8132554522
SUNCOAST
PAGE 01
. ,....,...:.... ClirNTRAL PEFtMJ:TT1.NJ3
-~'---'_.'._''P.'A''9CO COUNTY, FLO :;:rX>A
IN'fRAC'rcm tt II 013~7~
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)DI~:: 490:;! Er.SEN~'IOWER E{L.VD
1ST:: 'rAMPA PL ~~U)~<fJ
PATE:: 12/19/05 T!MIi!:.. 141154
PAGE II ~, OF:" :I.
r.SSUE OFFICEIl N
RECEIPT NUMBR I: O()aeiE:J~27
QFFICE:~ NJ:!:ld POFn RICHEY
JR:: SOL:CD WASTE FOR ZEP'FtI-IIL.L..S CHE~k: .. 6y:l~
F'ERMITS ~'4631~ 4d)?6;4655;S4p53f:5:~ir51
- . . <fJ634~~~~32;3'3;3()~~', ;34;:35; ,
JNTI:i:ACTOR;: O'J.~75 . ~ . J' Csh.o l) \cl. b -0 U tf 3 u
. ,'f'Cl'rAL AMOUNT J:. 33.. 28 '- -, I -(
:CNT COMPNY ACCOUNT CENTER AMOUNf 'DF.;SCRIPTJ:ON/Fl'ERMT DATA
1:1.4 :B450 - 363000 - 2 1~ .2..('1e tt***iUt . SOLI!) WASTE FEE:
t 14 B450 - 36;:t;OOO - . :2 '-\ .., - 3"',20 n**tHUt ~OL ID WASTr:': r:.EE
'T5/5.0
DR/CR
60
60
.b~,Llry31' ISJ~
:::CEIVED DY
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1 ZOQ-OBL-E 18 '0 N XU
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