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<br />. . <br /> <br />CENTRAL F ERMITTING OFFICES: <br /> <br />. Dade City: (904) 521-4206 <br />410 E. Meridan Ave, Rm 234, Dade City <br />. New Port Richey: (813) 847-8126 <br />7432 Little Road, New Port Richey <br />. Land O'Lakes: (813) 996-2203 <br />9930 Land O'Lakes Blvd (US 41), Land O'Lakes <br /> <br />THIS APPLICATION MUST BE TYPED OR PRINTED IN INK <br />AND IS VOID IF NOT PERMITTED WITHIN 6 MONTHS <br />------------------------------------------ <br /> <br />PASCO COUNTY BUILDING PERMIT APPUCA nON <br />SHADED AREAS FOR OFFICE USE ONLY <br /> <br /> <br />:lil: <br />(,) . OWNER'S NAME: <br />9 <br />m JOB LOCATION: <br />15 PARCEL 10#: S _ T _ R _ SUB <br />Z OWNER'S PRESENT ADDRESS: <br />~ <br />o <br /> <br />BLK <br /> <br />LOT <br /> <br /> <br /> <br />x <br /> <br />. FEE SIMPLE TITLEHOLDER'S NAME (if olher Ihan owner): <br />address (If applicable): <br /> <br />CITY <br /> <br />STATE <br /> <br />ZIP <br /> <br />------------------------------------------ <br /> <br />. DESCnlPTION OF WORK: <br />LIVING AREA: <br /># BEDROOMS <br /> <br />PATIO: <br /># BATHROOMS: <br /> <br />:lil: <br />g <br />...J <br />m <br />Z <br />o . IF MOBILE HOME OR RV: MAKE <br />i= <br />c. <br />~ <br />(,) <br />(/) <br />w <br />c <br /> <br />- <br />-- <br /> <br />GARAGE: ENTRY: TOTAL UNDER ROOF: <br />TYPE CONSTRUCTION: 0 BLOCK 0 FRAME 0 OTHER: <br /> <br />:lil: <br />9 <br />m <br />g . ELECTRICAL CONTRACTOR: <br />(,) SIGNATURE: <br />~ ADDRESS: <br />!Z STATE L1C # (if applicable): <br />8 POWER CO: <br /> <br /> <br />YEAR <br /> <br />SIZE <br /> <br />;:~::~&~K*r=:::::~; <br />. WORK CODE :m:\1#.dh"%'$$~ <br /> <br />PLANS ON FILE? 0 NO 0 YES <br />MODEL NAME: <br /> <br />VALUATION: $ <br /> <br />--------------------------------- <br /> <br /> . BONDING COMPANY: <br />'Sl: ADDRESS: CITY STATE ZIP <br />(,) <br />0 . ARCHITECT/ENGINEER: <br />...J <br />m <br />a: ADDRESS: CITY STATE ZIP <br />w <br />~ <br />.... . MORTGAGE LENDER: <br />0 <br /> ADDRESS: CITY STATE ZIP <br /> <br />---------------------------------- <br /> <br />. CONTRACTOR: <br />SIGNATURE: <br />ADDRESS: <br />STATE L1C # (if applicable): <br /> <br />PHONE# ( <br />CITY STATE <br />PASCO CO COMPUTER 10#: <br /> <br />ZIP <br /> <br />PHONE # ( <br />CITY STATE <br />PASCO CO COMPUTER ION: <br />SAWPOLE: <br /> <br />ZIP <br /> <br />AMPS: <br /> <br />. MECHANICAL CONTRACTOR: <br />SIGNATURE: <br />ADDRESS: <br />STATE L1C # (if applicable): <br />o NEW 0 ALTERATION VALUATION: $ <br /> <br />PHONE # ( <br />CITY STATE <br />PASCO CO COMPUTER ION: <br />(Required) <br /> <br />ZIP <br /> <br />. PLUMBING CONTRACTOR: <br />SIGNATURE: <br />ADDRESS: CITY <br />STATE L1C # (if applicable): <br /># FIXTURES: - SEPTIC PER #: <br /> <br />PHONE # ( <br />STATE ZIP <br />PASCO CO COMPUTER ION: <br />SEWER: WATER: <br /> <br />WELL: <br /> <br />. OTHER CONTRACTOR: <br />SIGNATURE: <br />ADDRESS: <br />STATE L1C # (if applicable): <br />TYPE CONTRACTOR: <br /> <br />CllY <br /> <br />PHONE#( ) <br />STATE ZIP <br />PASCO CO COMPUTER ION: <br />VALUATION: $ <br /> <br />JOBS UNDER $2,500 IN VALUE DO NOT NEED TO <br />RECORD AND POST A "NOTICE OF COMMENCEMENT" <br /> <br />(permit form 10/91) <br />EDITIONS OF THIS FORM RELEASED BEFORE 1/91 ARE OBSOLETE AND WILL NOT BE ACCEPTED BY CENTRAL PERMITTING STAFF <br /> <br />. . .. NOTiCE.... <br />BOTH THE OWNER AND CONTRACTOR OF RECORD (License Holder) MUST READ AND <br />SIGN THE REVERSE SIDE OF THIS APPLICATION <br />