HomeMy WebLinkAboutDavenport app revALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �{ �� Ll Permit Number.
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Buildin Permit Appikation
Planning and.Deve1dPment Services --
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Baildmg and
2300 VrginiaRven ie,, Fwt Pi m FL 38l82.-_
Phone: (772) 462-1553 Fax: (M) 462-7578 Commercial Residential x
PERMIT APPLICATION FOR: To Select horn dropbox, click arrow at the end of tine ..J ;,..9.., s
Address: Z`t'1 N E . NAA USa, OJT
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Legal Description: M.rtac- Qyont lam-. k Q ` 024 C it L,oi 1
Property Tax ID # .3l 1 57 it 00-C _ pd O Lot No- I t
Site Plan Name: Mid "Z)a Block No. 7n1
Project Name`
Setbacks Front Back: Right Side: Left Side:
one
ition win To un this permit— crill all thaa
0HVAC _Gas Tank Piping _Shutters E ind.111clors
�.Electrsc �Ptumbing ❑Sprutkl'ers flenerator Roof Roof pitch
Total Sq, FCof Construction: ' I t of First Floor'
Cost of Canstructiotr.S : ��' Caves ~ utilities: L=iSewerL�iseptie &sitdirng.Heighti :.
E Q
Mill
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. Name M-�� t �i vAo
3darsE: TAt:ataio'tlt --
Copanx. - Lowe's.t lane Ceiiter> 1 LC -
Address: Pi
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Address 2+{'l %iE tl sal
Stater
City
'i 93
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Zie: 3
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Phone No
E-Mail-
State
Zip 32878-i99:i Fax:
Zp Code:
Phone No- 112 - Illy 4 S�
&Mail: / 9 6 L r'e
Fill in flee sample Title Holder on nerd page (if dtfferertt
from the Owner Usted above)
State.orCctiatyliceense: C,Cf$084t7
If Wall ormerstrue:lionisS2Mor=onl RECORDED,110desof Cowanencellisfollil- -