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<br />, t <br /> <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />Date <br /> <br />'7- 02/ - 9,.s <br />8~ <br />. t. h_ 4z.. ---p~ <br /> <br />5335 8th Street <br />Zephyrhills, Florida 33540 <br />_1-813-788-6611 <br /> <br />Name <br /> <br />Address <br /> <br />legal Description <br /> <br />Building Perm. /I <br /> <br />Fee <br /> <br />Plumbing Perm. /I <br /> <br />Fee <br /> <br />Electrical Perm. /I <br /> <br />Fee <br /> <br />Mechn!. Perm. /I <br /> <br />Fee <br /> <br />No. of Sewer Conn. <br /> <br />No. of Water Conn. <br /> <br />No. of Water Meters <br /> <br />~/vJ =# ~~~I g <br /> <br />Transportation Impact Fee <br /> <br />Zone <br /> <br />+ 1% <br /> <br />Misc. <br /> <br />7/k <br /> <br />2-6'. ro <br /> <br />Total ~~ --.. Cl7J <br /> <br />Memo: <br /> <br />~A~ ~,)f~ft\ <br />)?-,;<J-y-!. ~ ~ ~. <br /> <br />Signature <br /> <br />WHITE: Bldg. Dept. <br />YELLOW: Utilities Dept. <br />PINK: Customer <br />