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<br />Building Permit Application Affidavit of Intent <br />White Aluminum Products, LLC 6005 W. Hwy. 17-92 Haines City,FL <br />I, ___K..e_i_"-~_~:._~~~~_::.!'::!!.:.?~!,~o hereby state that this building 86 j ~ g~t 3 441 <br />. Contractor 4801 Airport Rd. #214 <br />Permit application for _~e"'p_hJJ_h_i_~~~!.._~~_~~~~~_________is for a <br />Location <br />N Smith, Ray & Kathleen . . <br />ew clistomer____________________________or IS a Spec urnt. <br />Customer Name <br /> <br />I also will have the building permit application picked up <br /> <br />Within 30-days of notification that the application is ready, <br /> <br />I can be contacted at .!Jill~-BillJ--J>_0_iL_~~1._=_2.2Q.=2~~1____or Fax: 5286 <br />Phone <br />------.:..-------------------------------. I further understand <br />E-Mail <br /> <br />That in order to pick up the application and have the permit <br /> <br />Issued I vvill need, as a minimmn, to bring the following: <br /> <br />(if applicable) <br /> <br />1- <br /> <br />1. Deed shovving ownership of the lot. <br /> <br />2. NOC or affidavit required by Section 713, Florida <br />Statutes (over $2500.00) ($5000.00 if mechanical) <br /> <br />3. Utility Receipt or where applicable the Septic Permit from <br />Health Department (if needed). <br /> <br />4. Customer addressed stamped envelope (if NOC is <br />Required). <br /> <br /> <br />Signa ture:-~~.::..&A___________________________ <br /> <br />NAME. Dale Hall-POA <br />------------------------------------------------------- <br /> <br />CONTRACTOR PASCO ill #:______0_1_~~~~_____________________ <br />