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<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) 929-1266 <br />4111 Land O'Lakes Blvd. (US 41), Land O'Lakes <br /> <br /> <br />CENTRAL PERMlmNG OFFICES: <br /> <br />THIS APPLICATION MUST BE TYPED OR PRINTED IN INK <br /> <br />8 . OWNER'S NAME: CUi'I\~\o.(l\fI\~- (-(olhes <br />~ JOB LOCATION: 6zz.\ Silver Oa.Jc.s <br />II: PARCEL 101: S ~ T Z b R.!::L SUse'Z,4 BU< oa:x>~ <br />~ OWNER'S PRESENT ADDRESS: 7.;l.31 '-ftr~ P.Oq~ <br />~ <br />o <br /> <br />LOT <br /> <br />. FEE SIMPLE TITLEHOLDER'S NAME (II olher than owner): <br />address (II applicable): <br /> <br /> . BONDING COMPANY: <br />~ ADDRESS: CITY STATE ZIP <br />0 <br />9 . ARCHITECT/ENGINEER: <br />m <br />II: ADDRESS: CITY STATE ZIP <br />w <br />j: . MORTGAGE LENDE <br />0 <br /> ADDRESS: CITY STATE ZIP <br /> <br /> <br />CITY <br /> <br />STATE <br /> <br />ZIP <br /> <br />. DESCRIPTION OF WORK: <br />LIVING AREA: <br /># BEDROOMS <br /> <br />~ <br />8 <br />..J <br />m <br />~ . IF MOBILE HOME OR RV: MAKE <br />~ <br />a. <br />~ <br />o <br />Ul <br />w <br />c <br /> <br />SIZE <br /> <br />. WORK CODE: _ PLANS ON FILE? <br />MODEL NAME: <br /> <br />If,() (S.b() <br /> <br />o NO 0 YES <br /> <br />VALUATION: $ <br /> <br /> <br />.~(". <br />". PHONE#(~/3 )K'(p9 -c45B :. <br />~ CITY PASCO ~ ~MPUTER IOII~TATE /J?()O~~~................... ... ................ ....... <br /> <br />~ . ELECTRICAL CONTRACT.OR: '- - L/<1e- Ekcfr~ g~ ..Eu:bTRI~~~.. <br />~ ~~DN:;:m9F27~. CITY 6pr/YIb MiIONE;T~TE ,Jj, ZIP - ~ 0 IOFEei$t> <br /> <br />8 ~~~:RL~o~ (if apPlicableA..,...~ ~c_ SA:~ CO COMPUTER lOll: Iof!;: O^ ./ :;::;:;;;.;/...:r::::;..:...::..)i..;:;...::;).:::::;::.::.i....; <br /> <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 CONTRACTO <br />SIGNATURE: <br />ADO <br />STATE L1C # (if applicable): <br /># FIXTURES: <br /> <br /> <br />j)~k <br /> <br /><J.-yl G I <br /> <br />- SEPTIC PER #: <br /> <br />. OTHER CONTRACTOR: <br />SIGNATURE: <br />ADDRESS: <br />STATE L1C # (If applicable): <br />TYPE CONTRACTOR: <br /> <br />PHONE # ( ) <br />CllY STATE ZIP <br />PASCO CO COMPUTER lOll: <br />VALUATION: $ <br /> <br />JOBS UNDER $2,500 IN VALUE DO NOT NEED TO <br />RECORD AND POST A "NOTICE OF COMMENCEMENT" <br /> <br />. " ." NOTICE"... <br />BOTH THE OWNER AND CONTRACTOR OF RECORD (Ueense Holder) MUST READ AND <br />(permit form 10/91) SIGN THE REVERSE SIDE OF THIS APPLICATION <br /> <br />EDITIONS OF THIS FORM RELEASED BEFORE 1/91 ARE OBSOLETE AND WILL NOT BE ACCEPTED BY CENTRAL PERMITTING STAFF <br />PC93043032 <br />