HomeMy WebLinkAboutGuest House Affidavit1
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
GUEST HOUSE AFFIDAVIT
I hereby affirm that Building Permit # 07—n& D
is to be issued for a guest house which will not be used for rental purposes, seasonally
or annually, under any circumstances.
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Print Owner's Name Signature of Owner
STATE OF FLORIDA `
COUNTY OF
The f regoing instrument was acknowledged before me this _ day of 20 by �_� 1 c� �C (, b P_-fsonally known to me or who a produ
n Al • V P ., as identification.
Signature ofNotary
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Commission Number notary stamp
AUDREY B. HUMPHREY
MY COMMISSION # GG 300817
EXPIRES: March 6, 2023
Bonded Thru Notary Public Underwriters
SLCPDSD Revised 08/24/2010