Laserfiche WebLink
<br />PASCO COUNTY BUILDING PERMIT APPUCATION <br />SHADED AREAS FOR OFFICE USE ONLY <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 Utile Road, New Port Richey <br />, Land O'Lakes: (813) <br />9930 Land O'Lakes Blvd (US 41), Land O'UIkes <br /> <br />THIS APPLICATION MUST BE TYPED OR PRINTED IN INK <br />AND IS VOID IF NOT PERMITTED WITHIN 6 MONTHS <br />------------------------------------------ <br /> <br />(813) 92g.1266 <br /> <br />:.l': <br />9 <br />c:o <br />II: <br />W <br />z <br />3: <br />o <br /> <br /> <br />, FEE SIMPLE TITLEHOLDER'S NAME (If other than owner): _ __ <br />address (if applicable): CITY STATE ZIP <br /> <br />:-;;ESCnlPTION OF WORK: -C::C;.Jct<..r.FtL - ~/M~7"'v-- CcJ' --5~-Z;~~-------- <br />LIVING AREA: PATIO: GARAG . ENTRY: TOTAL UNDER ROOF: <br /># BEDROOMS # BATHROOMS: _-_ TYPE CONSTRUCTION: 0 BLOCK 0 FRAME 0 OTHER: <br /> <br />III <br />g <br />...J <br />c:o <br />Z <br />o . IF MOBILE HOME OR RV: MAKE <br />1= <br />c.. <br />ii: <br />() <br />(/) <br />W <br />Q <br /> <br />. MECHANICAL CONTRACTOR: <br />SIGNATURE: <br />ADDRESS: <br />STATE L1C # (if applicable): <br />o NEW 0 ALTERATION VALUATION: $ <br /> <br /> <br />YEAR <br /> <br />SIZE <br /> <br />. WORK CODE: i~i~i\i."1 PLANS ON FILE? <br />MODEL NAME: <br />C. C),~ C/O <br />VALUATION: $ 0 I' S U .-/ <br /> <br />o NO 0 YES <br /> <br /> . BONDING COMPANY: <br />III ADDRESS: CITY STATE ZIP <br />() <br />9 . ARCHITECT/ENGINEER: <br />c:o <br />II: ADDRESS: CITY STATE ZIP <br />w <br />~ . MORTGAGE LENDER: <br />0 <br /> ADDRESS: CITY STATE ZIP <br /> <br />:.l': <br />9 <br />c:o <br />15 . ELECTRICAL C <br />t; SIGNATURE: <br />~ ADDRESS: - (, <br />~ STATE L1C # (if applicable): <br />8 POWER CO: <br /> <br />PHONE # ( J. <br />HlA.A.s.c...-. STATE /1- ZIP 31/'(, ~ <br />PASCO CO COMPUTER 10M: / 32~ <br />SAWPOLE: AMPS: <br /> <br />. PLUMBING CONTRACTOR: /rJl2.{ SO IV <br />SIGNATUR : <br />ADDRESS: ) Ldl1.. (/ffft'> r.'1C1TY <br />STATE L1C # (if applicable): Co 3 'fJf'S" <br /># FIXTURES: - SEPTIC PER #: <br /> <br /> <br />PHONE # ( <br />CITY STATE <br />PASCO CO COMPUTER 10M: <br />(Required) <br /> <br />ZIP <br /> <br /> <br />---------------------------------~.:..:.. <br /> <br /> <br />. OTHER CONTRACTOR: <br />SIGNATURE: <br />ADDRESS: <br />STATE L1C # (il applicable): <br />TYPE CONTRACTOR: <br /> <br />PHONE # ( ) <br />CITY STATE ZIP <br />PASCO CO COMPUTER IDM: <br />VALUATION: $ <br /> <br />OTHER FEE TYPE: <br /> <br />JOBS UND&R $2,500 IN VALUE DO NOT NEED TO <br />RECORD AND POST A 'NOTICE OF COMMENCEMENT" <br /> <br />TOTAL BUILDING PERMIT FEE: <br /> <br />$ <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 (Ucense Holder) MUST READ AND <br />SIGN THE REVERSE SIDE OF THIS APPLICATION <br />