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<br />PASCO COUNTY BUILDING PERMIT APPUCAnON <br /> <br />CENTRAL PERMITTING OFFICES: <br /> <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 Uttle 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 /> <br />------------------------------------------ <br /> <br />~ <br /> <br />~ .~0~NL~~~~~~~:13j~/ )Jf~f~~j J?r <br /> <br />ffi PARCEL 101: S 3)' T 2 <) R...2..LSUB 60 -50 BLKVt?,o",t'J <br />~ OWNER'S PRESENT ADDRESS: 5 t:( , J1 -t:' . <br />o <br /> <br />PHONE#( ?/3 ).2ff..iL-? ? 79 <br />LOT OJ 3 d#Rolt6€ii~:~:l:~~L:::r:~:;::1;:::'~k\::r?~:1} ~~:S~~ X <br />"'ciTY:"'?~ Pi]!" #:li;....STATE:~ZIP '] yry,; <br /> <br />. FEE SIMPLE TITLEHOLDER'S NAME (if olher Ihan owner): <br />address (if applicable): CITY STATE ZIP <br /> <br />~ESC~TIONOF~~-~R~;7---------------------------- <br />8 LIVING AREA: PATIO: GARAGE: ENTRY: TOTAL UNDER ROOF: <br />...I # BEDROOMS #BATHROOMS:__ TYPE CONSTRUCTION: o BLOCK OFRAME o OTHER: <br />a:l <br />5 <br />~ <br />Q. <br />ii: <br />o <br />l/) <br />W <br />Q <br /> <br /> . BONDING COMPANY: <br />.s!:: ADDRESS: CITY STATE ZIP <br />9 . ARCHITECT/ENGINEER: <br />a:l <br />a:: ADDRESS: CITY STATE ZIP <br />w <br />i= . MORTGAGE LENDER: <br />0 <br /> ADDRESS: CITY STATE ZIP <br /> <br /> <br />. IF MOBILE HOME OR RV: MAKE <br /> <br />YEAR <br /> <br />SIZE <br /> <br />. WORK CODE: <br /> <br />PLANS ON FILE?: 0 NO <br /> <br />o YES <br /> <br />VALUATION: $ 2. 17 7 )"' <br /> <br />--------------------------------- <br /> <br />--------------------------------- <br /> <br />. CONTRACTOR: <br />SIGNATURE: <br />~ ADDRESS: - 5- <br />9 STATE L1C # (if applicable): <br />a:l <br />a:: <br />e <br />o <br />< <br />a:: <br />... <br />z <br />o <br />o <br /> <br />. ELECTRICAL CONTRACTOR: <br />SIGNATURE: <br />ADDRESS: <br />STATE L1C # (if applicable): <br />POWER CO: <br /> <br />PHONE # ( <br />CITY STATE <br />PASCO CO COMPUTER 101: <br />SAWPOLE: <br /> <br />ZIP <br /> <br />AMPS: <br /> <br />. MECHANICAL CONTRACTOR: <br />SIGNATURE: <br />ADDRESS: <br />STATE L1C # (if applicable): <br />ONEW OALTERATION VALUATION: $ <br /> <br />PHONE # ( <br />CITY STATE <br />PASCO CO COMPUTER 101: <br />(~equired) <br /> <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 101: <br />SEWER: WATER: <br /> <br />WELL: <br /> <br />---------------------------------- <br /> <br />. OTHER CONTRACTOR: <br />SIGNATURE: <br />ADDRESS: <br />STATE L1C, (if applicable): <br />TYPE CONTRACTOR: <br /> <br />PHONE # ( ) <br />CITY STATE ZIP <br />PASCO CO COMPUTER 101: <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 4/91) <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 (Ucense Holder) MUST READ AND <br />SIGN THE REVERSE SIDE OF THIS APPLICATION <br />