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<br />Building Permit Application Affidavit oj intent <br />1~Q.~.fS~~r " do hereby state that this building <br /> <br />Contractor <br /> <br />Permit application for ~3C;; /d6f/ is for a <br /> <br />Location <br /> <br />New customer):kA~,.c.-.4t C?/U.Jk4 or is a Spec unit. <br />Customer Nah1e <br />I also will have the building permit application picked <br /> <br />up within 3D-days of notification that the application is <br /> <br />Ready. I can be contacted attsl::)-i88 _I '555" or <br /> <br />.. Phone , <br /> <br />r:xiC:Q2..S~(,CDVI~W'-H{)n .(l)- . I further understand that <br />~ E-mail . <br />in order to pick up the application and have the permit <br /> <br />issued I will need, as a minimum, to bring the <br /> <br />Following: <br />F' . l <br />1. Deed showing ownership of the lot <br />'2. NOe or affidavit required by Section 713, Fiorida <br />Statutes . <br />3. Utility Receip.t or where applicable the Septic <br />Permit from Health De artment <br /> <br /> <br />Signature: <br /> <br />Name~~ S <br />Contractor No.: Q.RCJ tfSl4 7 {.J <br />