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<br />Building Permit Application Affidavit of Intent <br /> <br />I, ~\r;y"\ L<.~ , do hereby state that this building <br /> <br />Contractor <br /> <br />Permit application for ~CtLI )t\.). k~ 0... . is for a <br /> <br />Location <br /> <br />New customer ~A Act:.\, f"'\ or is a Spec unit. <br /> <br />Customer Name <br /> <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 at 3~ 777 CfigS or <br /> <br />Phone <br /> <br />.r-\cr'c\2. ~~ CD ~GClf'Y'.. 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 />1. Deed showing ownership of the lot <br />2. NOC or affidavit required by Section 713, Florida <br />. Statutes <br />3. Utility Receipt or where applicable the Septic <br />Permit from Health D ment <br /> <br />Signature: <br /> <br /> <br /> <br />Name:::s2)V"'>~ ~~-"- <br />Contractor No.: 0) 543'1 <br /> <br />'" <br />