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<br />I <br /> <br />. Building Permit Application Affidavit ofint~nt <br />I <br />I, ,J;~J ".~"';JJ ~. ,do hereby state that t is building <br /> <br />Conrractor . <br /> <br />Permit application for 770"1 61 is for a <br />Location L <br />New customer 1/,..r"L....+ c.,r-......." . or is a ~pec unit. <br /> <br />I also will have theb~fiding permit apPlicatirn picked <br /> <br />up within 30-days of notification that the applicatiGn is <br /> <br />Ready. I can be contacted at or <br /> <br />S."J "J bj e +._d. Iw.,. ,-,.. ,.... I further under tand that <br />~~ ' I <br />in order to pick up the application and havel the permit <br /> <br />issued I will need, as a minimum, to bring t1e <br /> <br />Following: I <br />1. Deed showing ownership of the lot . . <br />2. NOC or affidavit required by Section 7~ 3, Florida <br />. Statutes . II , <br />3. Utility Receipt or where 'applicable the ~eptic <br />Permit from Health Department <br /> <br />Signatlire: ~ ~ ..,;:l- <br /> <br />Name: C <br />Contractor No.: '- Go Co'1 ., i'" 'Z. 2.. <br />