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<br />" <br /> <br />. . <br /> <br />Building Permit Application Affidavit o~ Intent <br /> <br />I,_~ejC..L=-MA:'fL__________,do hereby stat~ thqt this building <br />(ontractor <br />Permit application for _J'3..tl:::3-_flLfl.f-'l.__~'=.9f?J:..._-'2L__is for a <br />. Location . <br /> <br />New customer ~.ffjP4LIJLIIJ.._.2?t.~&dcA_or is a Spec unit. <br />Customer Name .. <br /> <br />I also will have the building permit application picked up <br />Within 30-days of notification that the application is ready, . <br />I can be contacted at-_?~-L__f'~~_=L2-f3-_________or <br />'. Phone <br />----LVld----------:-~_________________; I further understand <br />. .. E-Mail <br /> <br />That in order to pick up the application and have the permit <br /> <br />Issued 1 will need, as a minimum, to bring the following: <br /> <br />(if applicable) <br /> <br />1. Deed showing 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 />Signature:_.4~;L~~_____________~___________~_ <br />NAME:_Yl7-_L/d4g~~______________________________ <br />. CONTRACTOR PASCO in .#:----~{_~~.5_S_2------____________ <br />