HomeMy WebLinkAbout12846 (6) �r CITY OF DIAMOND BA8 �
-- � DEPARTMENT OF COMMUNFTY&DEYEFAPMENT SERVICES �
� 21660 E.Copley Drive 5uite 190
(904)860-3195 Fax(909)861-3117 PRESS
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1 HEREBYAFFIRM UNDER PENAL7Y OF PERJURY iHAT THERE IS A CONSTRUCTqN LENDINO AOENCY
FOR T11E PERFORMANGE OF THE WORK FORNRIICH TXIS PERMIT IS ISSUED(SEC.iaY7.CIV.C.�.
� LENDEiY9 NAME ��Il�L
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LENDER'SADDRESS
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`n CONSTRUCTION.AND NEREBY MlTilOH12E REPRESENTATNES OF TI115 COUNTY TO ENfER UPON 1NE
� ABOVE•MEIRIONED PROVERTY FOR II�PECTION PURPOSES.
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� RECPT.NO. PAID BY , YALlDATION
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TEMP PC)WER FIREPLACE BaND SEAM - � - ' - � �' `
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ROOF SI-fEATHING ����� 8 FT.80ND BEAM
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R�OF COVER PRE-GRADING � �
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ROUGN ELECTRIC RDUGH GRADING
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FINAL ELECTRIC DEV. FEES PAID
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