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<br />'/,-- oh' j 1-hcei.S <br />~ASCO COUNTY BUILDING PERMIT APPLICATIONC-{ r' .....,., <br /> <br />_ OFFICE USE ONLY <br />OCCUPANCY <br /> <br />NEW PORT RICHEY <br /> <br />(813) 847-8126 <br /> <br />NO. OF UNITS <br /> <br />LAND 0' LAKES <br /> <br />TYPE OF CONST. I II III IV V VI <br /> <br />(813) 996-2203 <br /> <br />FIRE DISTRICT <br /> <br />DADE CITY <br /> <br />APPLICATION MUST BE TYPED OR PRINTED IN INE. <br /> <br />(904) 521-4206 <br /> <br />I MAX ROTHENBURS <br />OWNER S NAME 4534 CItAItTEIl STftE~~:~ l.~ <br />JOB LOCATION 1 ' SUBDIVISION 1J (tl.lt--u. s fU-. <br />Sli T~ R.JJ S~ BLQf3~DDLOT'~ROJEC~Tf TAZi.' LOT SIZE X <br />'. "It!f: ~ CHAl<' STREE. ZEPHYRHILLS-:=-T3S41J <br />OWNER'S PRESENT ADDRESS ",ITY / STATE ZTP <br />BUILDING CONS'l.'Rff~ ~ :AGER JR. AIR CONTROL SYSTEM SW ST II CAC 035496 <br />SIGNATURE ~~ COMP ID tt (ci);l.'S' <br />PRESENT ADDRESS 1612 SEABOARD ST FORT MYERS TELEPHONE II 541-7600 <br />~QUAL CHANGE-OUT OF 3.5 TON STRAIGHT COOL PACKAGE UNIT <br />DESCRIPTION OF WORK <br />LIVING AREA PATIO GARAGE ENTRY <br />NO. OF BEDROOMS NO. OF BATHROOMS TYPE OF CONST: BLOCK <br /> <br />TOTAL UNDER ROOF <br />FRAME OTHER <br /> <br />Nfu~, YEAR, AND SIZE OF MOBILE HOME <br />WORK CODE IJ e C- PLANS FEE <br />TOTAL VALUATION $3101. 00 <br /> <br />REC.fl FOR PLANS FEE PD <br />TOTAL BLDG. FEE <br /> <br />PLANS FEE <br /> <br />- - - - - - - - - - - - - - - - - - - - - - - - - - <br /> <br />ELECTRI C CONTR. NAME <br /> <br />SIGNATURE <br /> <br />POWER CO. <br /> <br />ST. II <br />COMPUTER ID. fl <br />TOTAL ELECTRIC FEE <br />STATE /I <br />COMPUTER ID. II <br />TOTAL MECHANICAL FEE <br />ST. fl <br />COMPUTER ID. /I <br /> <br />SAWPOLE <br /> <br />AMPS <br /> <br />MECHANICAL CONTR. NAME <br />SIGNATURE <br />NEW ALTERATION <br />PLUMBING CONTR. NAME <br />SIGNATURE <br />FIXTURES SEPTIC/I_____ SEWER <br />ANY OTHER TYPE CONTRACTOR'S NAME <br />SIGNATURE <br /> <br />2ie& <br /> <br />VALUATION <br /> <br />WATER <br /> <br />TOTAL PLUMBING FEE <br />ST. II <br />COMPUTER ID. /I TOTAL FEE <br />TOTAL RADON FEE <br />OTHER FEES <br />TOTAL PERMIT APPLICATION FEE <br /> <br />WELL <br /> <br />FLOOD PL <br />SETBACKS <br />COMMTh'TS <br /> <br /> <br />2(j? qrz <br /> <br />BFE <br /> <br />ZONE <br /> <br />j>/J (' kft b~ //# ~ /,7,./A1A/~.e r::7/V ./- <br /> <br />CONTROL il <br /> <br />FAILURE TO COMPLY WITH THE MECHANIC'S LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING <br />TWICE FOR IMPROVEMENTS TO THE PROPERTY. <br /> <br />SEE REVERSE SIDE FOR CONDITIONS OF PERMIT. PLEASE READ AND SIGN BOTH SIDES. FOR PERMIT <br />VALUATIONS OVER $2,500, A NOTICE OF COMMENCEMENT SHOULD BE FILED. OWNER MUST COMPLETE <br />RECORDING OF NOTICE OF COMMENCEMENT MIl) .POST WITH BUILDING PEP.MIT(S) PRIOR TO FIRST IN- <br />SPECTION ON SITE. <br /> <br />CONTRACTOR AGElIT/OWNER SIGNATtlIlE ~ ~~ <br />(READ & SIGN SE SIDE <br />pe:-njt:cci: I <br /> <br />. G c:' <br />DATE r /- 1/ <br />