03-2383 - Laserfiche WebLink

Browse Search

PASCO COUNTY BUILDING PERMIT APPLlCAnON CENTRAL PERMrmNG OFFICES: SHADED AREAs FOR OFFICE USE ONLY · Dade City: (352) 521-5144 FAX (352) 521-5149 0CCllPANc'I: SECt: . a '19 f3.;) '3852 17th St., Dade City · New Port Richey: (727) 847-8126 FAX (727) 847-8901 NO. OF UNITS: 7530 Uttle Rd.. Rm. 210 New Port Richey RRE DISTRICT: PERMIT#: · Land Q'Lm<es: (813) 929-1266 FAX (813) 929-1307 1YPE C<lNSTRUCTloN' I II III r>I V VI 4111 Land O'Lakes Blvd. (US 41), Land O'Lakes . ft= THIS APPLICATION MUST BE TYPED OR PRINTED IN INK DATE RECEIVED: 8-- ~ BY: AND IS VOID IF NOT PERMlffiD WITHIN 6 MONTHS -------------------------------------------------------------------------------------------- --- --------- IS THIS APPLICATION THE RESULT OF A STOP WORK ORDER OR NOTICE OF VIOLATION? y _ N-=::.. G OWNER'S NAME: -.t1 an /.\.e.l ~ ut Ie z. PHONE # (_) 9 JOB lOCATION: 374 S I tV ~ IY) A vt-. SUBDIVISION: Gro.nd 1+0 r iZ-b", S ~ PARCEllD#: S ~ T ~ 5" R ~ SUB Qf&2 BU< ~ LOT 11./00 PROJECT # TAZ _ LOT SIZE 79' x lQi:.. ~ OWNER'S PRESENT ADDRESS: St1~ CI1Y: Zephyr"'.. ,,~ STATE: fl. ZIP: 33~C/ / ;: o FEE SIMPLE TITLEHOLDER'S NAME Of other than owner): address (if applicable): CI1Y: STATE: ZIP: ---------------------------------------------------------------------------------------------------------- DESCRJPllONOFWORK: G\.n ~ 5cr~~ 12M -Tv ClAss Po..t- Covo-- a../l ~ l'st. ahs G UVING AREA: ..< ~O t:/J PATIO: ~ 35" GARAGE: ENTRY: TOTAL UNDER ROOF: 'f S-.s- ttJ 9 # BEDROOMS - # BATHROOMS -- _ TYPE CONSTRUCTION: 0 BLOCK 0 FRAME ,QtOTHER: tAl /.uf;t.(;"u............ ca FILL Y _N_ ~ IF MOBILE HOME OR RV: MAKE t= a.. a: WORK CODE u en w C PASCO PERMIT SERViCE PHONE # ( _ ) 813-788-5314 CITY: STATE: _ ZIP: PASCO CO COMPUTER 10#: '14 70 YEAR SIZE PRE-PAID PLANS FEES: $ CITY: STATE: _ ZIP: CITY: STATE: _ ZIP: CITY: STATE: ~ ZIP: ----------------------------------------------- MECHANICAL CONTRACTOR: SIGNATURE: ADDRESS: STATE UC # Qf applicable) o NEW 0 ALTERATION VALUATION: $ PHONE# (_) CITY: STATE: _ ZIP: PASCO CO COMPUTER 10#: (Required) PLUMBING CONTRACTOR: SIGNATURE: ADDRESS: STATE UC # Of applicable) # FIXTURES: SEPTIC PER # PHONE # (_) CITY: STATE: _ ZIP: PASCO CO COMPUTER 10#: SEWER: WATER: WEll: OTHER CONTRACTOR: SIGNATURE: ADDRESS: STATE UC # (if applicable) TYPE CONTRACTOR: PHONE# (_) CITY: STATE: _ ZIP: PASCO CO COMPUTER 10#: VALUATION: $ --------------------------------------------------------------------------------- OTHER FEE TYPE: AMOUNT: $ RECEIPT#: --------------------------------------------------------------------------------- JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT" TOTAL BUILDING PERMIT FEE: · · · · NOTICE. . . . BOTH THE OWNER AND CONTRACTOR OF RECORD (License Holder) MUST READ AND SIGN THE REVERSE SIDE OF THIS APPUCATION FEES BlOCK PlANS FEE: $ BUILDING: $ B.ECTRICAL FEE: s MECHANICAL . FEE: $.. PLUMBING FEE: $ ....._, . ....-......... '. ....... ....... RADON FEE: S'. .....$ . (pennit form 101911 EDITIONS OF THIS FOAM RElEASED BEFORE 1/91 ARE OBSOLETE AND WILL NOT BE ACCEPTED BY CENTRAL PERMITTING STAFF PC930430321G (~