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<br />PASCO COUNTY DEVELOPMENT REVIEW DIVISION <br />INTERIOR REMODELlNGS AND ADDITIONS <br />(To be Completed by Contractor) <br /> <br />PROJECT: ~O~ ~ CONTROL NO: <br /> <br />CONTRACTOR: 4YY1.'.~'. ~ oLhJi;uri~ DATE: <br /> <br />EXISTING CONDITIONS <br /> <br />SPECIFIC EXISTING BUILDING USE: <br />ELECTRICAL SERVICE SIZE(S): ;;2.q) A-VV\ P <br />NO, EXISTING BATHROOMS: "2- <br /> <br />SF BUILDING AREA: <br /> <br />27C1? <br /> <br />EXISTING L.P, GAS APPLlCANCES: YES /'No <br />NO, EXISTING PLUMBING FIXTURES: '1. <br /> <br />EXISTING MECHANICAL: VCJ' <br />{ <br /> <br />Existing NC: <br />Existing Heat: <br />Existing Ventilation: <br />Existing Refrigeration: <br /> <br />/YES <br />_,,/'{ES <br />~YES <br />YES <br /> <br />NO <br />NO <br />NO <br />.........NO <br /> <br />SPECIFIC BUILDING USE: <br /> <br />FinCfl'le;",J <br /> <br />ScrVI U'S <br /> <br />SF BLDG, AREA: '2/0'1 <br /> <br />STRUCTURAL CHANGES/ADDITIONS: <br /> <br />(\I / II <br /> <br />VALUATION: <br /> <br />PLUMBING CHANGES/ADDITIONS: <br /> <br />IV/A <br /> <br />SEPTIC: <br /> <br />UT. CO. <br /> <br />Number of Bathrooms: <br /> <br />Number of Additional Bathrooms: <br /> <br />Number of Fixtures to be Changed Out: <br /> <br />Number of Additional Fixtures: <br /> <br />/ h (\ <br />ELECTRICAL CHANGES/ADDITIONS: NTEl!.lot:.. FINISH of Of&:A/ ~HELI AS' tPe:.de (>RII\Ir <br />Change in Service Size(s): _ YES (From _ to ~ <br /> <br />Number of Additional Lights: <br /> <br />bV <br /> <br />Number of Additional Outlets: <br /> <br />45 <br /> <br />MECHANICAL CHANGES/ADDITIONS <br /> <br />VALUATION: <br /> <br />Additional NC: <br />Additional Heat: <br />Additional Ventilation: <br />Existing Refrigeration: <br /> <br />YES <br />YES <br />YES <br />YES <br /> <br />~O <br />.L1'JO <br />~O <br />_/f;[o <br /> <br />L.P, GAS CHANGES/ADDIT!ONA: <br /> <br />YES <br /> <br />...:::(No (If YES, Separate Per:nit Required) <br /> <br />OTHER CURRENTLY ACTIVE BUILDING PERMIT NUMBERS FOR BUILDING: <br /> <br />THIS FORM MUST BE COMPLETELY FILLED OUT. THE PLANS WILL NOT BE ACCEPTED WITHOUT ALL ITEMS <br />ADDRESSED. <br /> <br />I ACKNOWLEDGE THAT ALL ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE <br />AND BELIEF, <br /> <br />SIGNATURE fl1J;; 5J <br /> <br />DATE: {, /0" /03 <br />