03-1862 - Laserfiche WebLink

Browse Search

PASCO COUNTY BUILDING PERMIT APPLICATION CENTRAL PERMITTING OFFICES, · SHADED AREAs FOR OFFICE USE OfJIL't" /l · ~ade City: (3521521-51~ FAX 13521521-5149 OCCUPANCY- SEa"~ DC. (ff1 c;t--rr ,3852 17th St.. Dade City _, --1l. · New Port Richey: (727) 847-8126 FAX (727) 847-8901 NO. OF UNITS: 7530 uttle Rd.. Rm. 210 New Port Richey FIRE DISTRICT: · Lana O'Lakes: 18131929-1266 FAX 18131929-1307 .i 111 Land O'Lakes 8lvd, IUS 41 \, Lane O'Lakes TYPE CONSTRUCTION . -CIS APPUCATlON MUST BE 1YPED OR PRINTED IN INK cATE ;,ESE'VED: J-I, res. ':'ND IS VOID IF NOT PERMITTED WITHIN 6 MONniS ---------------------------------------------------------------------------------------------------------. S TIiIS APPLICATION THE RESULT OF A STOP WORK ORDER OR NOTICE OF VIOLATION? :' _ .'-J_ 13 OWNER'S NAME: NANCY MILLER / ZI4-c...K- rf'L.tJ r FHONE _ I , 779-3623 ~ J08LCCATlON: 6042 PLEASANT ST Z/HILLS SU8DIVISION: -o-~l~ A'll-l-f' ~ oAACElIOl: S ~ T "" "~SUB oo.>p BUI> 0 30 oUlT"~ ffiOJECH TAl _LOT SlZE -C..-X_ ~ OWNER'S PRESENT ADDRESS:6042 PLEASANT ST enY: Z/HILLS STATE: FL ZIP: 33542 ~ FEE SIMPLE TITl.eiOLOER'S NAME Of other Ulan owneo: allClress lit apPlIcatlIe): ellY: STATE: ZIP: ~~~~~~~~~-~;~~;;:--iijOiBi1:E--A(jMEf-R-OO~~(jVEfR---N~-13A15------------______________________________. 13 UVING AREA: PAllO: GARAGE: ENTRY: TPJt4~NDER ROOF: 3 # BEDROOMS - # BATHROOMS - - _ TYPE CONSTRUCTION: 0 BLOCK 0 FRAME tt'crffiER: CIl ~1l.L Y _ N _ . , a IF M081LE HOME OR RV: MAKE Tw l ~ \;\-5 i= a. a: WORK CODE u C.I) w a VAlUATION S J e'SCf.- PERMIT#: :1 !II JJlV ::Y: v VI YEAR \ ~d I SIZE ~4 'I' l(.r FEES BLOCK PlANS ON FILE? 0 NO 0 YES MODEL NAME PRE.PAlD PlANS FEES: S PLANS FEE: S --------------------------------------------------------------------------------- REC8PT ,: BUILDING: $ SaNDING COMPANY: ::.: ADDRESS: u o a ARCiITECT/ENGINEER: a: ADDRESS: w i= o MORTGAGE LENDER: AOORESS: enY: STATE: _ ZIP: erTY: STATE; _ ZIP: --------------------------------------------------------------------------------- CrTY: STATE; _ ZIP: CONTRACTOR: SIGNATURE: ::.: ADDRESS1 ~7t::..L.. ',' g STATE UC , Of appj.cablel ~ CIl a: g ELECTRICAl. CONTRACTOR: ~ SIGNATURE: .... ADDRESS: a STATE UC , (it ~caDlel U POWER CO: M T r"~OC'I M' U;lgOV OMq TOMOO '- PHONE' (-l .5~o~JY.(r gC'I\'O qT CrTY: I C1gr::n STATE; EL..- ZleLa.~41 r"r::r" 01 ~ ~q77 PASCo CO COMPUTER 10': W Vh PHONE' (-l CrTY: STATE: _ ZIP: PASCO co COMPUTER 101: SAWPOLE: AMPS: ELECTRICAL FEE: $ MECHAN~LCONTRACTOR: ~ SIGNATURE: ADDRESS: STATE UC , ~f ~catlIe) o NEW 0 Al1ERATlON PHONE. (-I CrTY: STATE: _ ZIP: PASCo CO COMPUTER 101: VAlUATION: Sfi3Q'1A4 - 0101 (RtQUrecll MECHANICAL FEE: $ PlUMBING CONTRACToR: SIGNATURE: AOORESS: STATE UC , ~f ~PPbtllet , FIXTURES: SEPTIC PER , PHONE' (_) CITY: STATE; _ ZIP: PASCO co COMPUTER 101: SEWER: WATER: WELL.: PLUMBING FEE: S OTHER . BLOG. FEE: $' OTHER CONTRACToR: SIGNATURE: ADDRESS: STATE UC , Of ~caDlel TYPE CONTRAcTOR: PHONe. (-I Cnv: STATE: _ ZIP: PASCO CO COMPUTER 101: VAlUATION: $ --------------------------------------------------------------------------------- OTHER FEE TYPE: AMOUNT: S REC8PT': RADON FEE: $ $ --------------------------------------------------------------------------------- JOBS UNDER $2,500 IN VALUE 00 NOT NEED TO RECORD AND POST A -NQT1CE OF COMMENCEMENr TOTAL BUILDING PERMIT FEE IPI/llII bm lC1/11) EDITIONS OF THIS FOAM AR 1=A.c:m R~l! .... ...... ......._. _ .. ._ ....NOT1CE.... BOTH THE OWNER AND CONTRAcTOR OF RECORD (Ucense Holder) MUST READ AND SIGN THE REVERse SiDe OF THIS APPUCATION