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<br />PASCO COUNTY BUILDIN~ PERKIT APPLICATION <br /> <br />OFFICE USE ONLY <br /> <br />NEW PORT RICHEY <br /> <br />OCCUPANCY <br /> <br />(813) 847-8126 <br /> <br />NO. OF UNITS <br /> <br />(813) 996-2203 <br /> <br />?/ /J-- <br /> <br />LAND 0' LAKES <br /> <br />TYPE OF CONST. I II III IV V VI <br /> <br />FIRE DISTRICT <br /> <br />DADE CITY <br /> <br />APPLICATION MUST BE TYPED OR PRINTED IN INK <br /> <br />(904) 521-4206 <br /> <br />A-l(lhk VI Ii CV\'L-~"~5 <br />OWNER I S NAME MANFRED NEIDLEIN ~.. , <br />7353 APPLEGATE ,.,ltC:t. <- L <br />JOB LOCATION SUBDIVISION <br />S ~r T lSR,1L SU t>o~I'rBLk-A~OX~~l,lROJECTf! TAZII l';/Hlt~1 SIZE_X_ <br />OWNER'S PRESENT ADDRESS CITY / STATI: ZIP <br />BUILDING CONSTR. NAME RICHARD YAGER JR. AIR CONTROL SYSTEM SW ST II <br />SIGNATUP~ COMP ID H <br /> <br />PRESENT ADDRESS l6l2 SEABOARD ST FORT MYERS <br />~ INSTALL HEAT RECOVERY UNIT <br />DESCRIPTION OF WORK <br /> <br />PATIO GARAGE ENTRY <br /> <br />NO. OF BATHROOMS TYPE OF CONST: BLOCK <br /> <br />TELEPHONE If <br /> <br />CAC 035496 <br />h 3?J-- <br />54l-7600 <br /> <br />LIVING AREA <br /> <br />TOTAL UNDER ROOF <br /> <br />NO. OF BEDROOMS <br /> <br />FRAME <br /> <br />OTHER <br /> <br />Nfu~, YEAR, AND SIZE OF MOBILE HOME <br /> <br />WORK CODE <br />TOTAL VALUATION <br /> <br />PLANS FEE REC.f! FOR PLANS FEE PD PLANS FEE <br />...... $ 950.00 TOTAL BLDG. FEE <br /> <br />ELECTRI C CONTR. NAME <br />SIGNATURE <br />POWER CO. SAWPOLE AMPS <br />MECHANICAL CONTR. NAME 4U(__ CtI )'\.-ry'{J I <br />SIGNATURE ~ ~ <br /> <br />ST. /I <br />COMPUTER ID. II <br />TOTAL ELECTRIC FEE <br />STATE II <br />COMPUTER ID. II <br />TOTAL MECHANICAL FEE <br />5T. II <br />COMPUTER ID. II <br /> <br />NEW <br /> <br />ALTERA TI ON <br /> <br />VALUATION <br /> <br />PLl~BING CONTR. NA~ <br />SIGNATURE <br /> <br />FIXTURES <br /> <br />SEPTIC/I <br /> <br />SEWER <br /> <br />WATER <br /> <br />WELL <br /> <br />TOTAL PLUMBING FEE <br /> <br />ST. II <br /> <br />ANY OTHER TYPE CONTRACTOR'S NAME <br /> <br />SIGNATURE <br /> <br />COMPUTER ID. f! <br />VALUATION $ <br /> <br />TOTAL FEE <br />TOTAL RAIlON FEE <br />OTHER FEES <br />TOTAL PERMIT APPLICATION FEE <br /> <br />OFFICE USE ONLY <br />PANEL II <br /> <br />zot-.'E <br /> <br />FLOOD PL <br />SETBACKS <br />COMMENTS <br /> <br />BFE <br /> <br />CONTROL if <br /> <br />FAILl~~ 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 P~\~SE SIDE FOR CONDITIONS OF PERMIT. PLEASE READ AND SIGN BOTH SIn~s. FOR PER~IT <br />VALUA':'IONS OVER $2,500, A NOTICE OF COMMENCEMENT SHOULD BE FILED. OWNER MUST COMPLETE <br />RECORD:NG OF l';OTI CE OF COMMENCEMTh'T AA'"D ,POST WITH BUILDING PEP~~IT( S) PRIOR TO FIRST IN- <br />SPEC:IO~ OK SITE. <br /> <br />3-'I-Q( <br /> <br />CONTRACTOR AGENT / O'WNRR SIGNATURE ~ __ __ <br />(READ & SIGN REVERSE SIDE) <br /> <br />DATE <br /> <br />r' ('l :-~- : 4 : <br />