HomeMy WebLinkAboutProject Information r� PLANNING & DEVELOPMENT
BOARDOF ` o:L�!IL+�L -- ' 'SERVICES DEPARTMENT"
COUNTY Ab
U �.. _
COMMISSIONERS o e •` �. Building;and Code'Regulation
Divislon
Electrical Affidavit
Date
ParcelID# 3' -O �_0'.a._- b66C.__
Address a:30:2- lrt Cats y2
Permit#42.DV0 63V,
I have requested to install-an.,additional electric service/meter at the above,named property: By
signing this affidavit]fully agree:thatthe additionaLelectrrcal service/meter-.does not allow'f5ethe
,following:
• Operation of a business venture_or entity within the-accessory structure in violation of the LDC
• Renting-or leasing any portion of the accessory structure.in violation of.the.LDC
• Converting accessory structure into additional-occupied,orf living space in violation of the LDC
I fully understand that.if the.conditions of this affidavit is.fo nd in violation, power may be-shut
off to the building without notice.
Print Owner's Name Sig `ture of O, ' er
STATE bi-`FLORIDA,COUNTY OF 5'f', L O-1
SWORN TO(OR'AFFIRMEDj AND SUBSCRIBED I3EFORE.ME OF PHYSICAL PRESENCE OR.
ONLINE NOTORIZATION THIS ON -- DAY OF !q ursruST' 2p`
NAMI:OF PERSON MAKING STATEMENT
PERSONALLY'KNOWN 9 OR PRODUCED IDENTIFICATION
TYPE OF ibENTIFICATtON.PRODUCED
wNATU OFNOTARY`PUBLIC TYPE.ORPRINT-NOTARY-
COMMISSION NUMBER
E'CARUANA
MY COMMISSION#-13G128195
"Re. EXPIRES July 25,2021
Website:www.stluclecomv
2300 Virginia Avenue-Fort Pierce;FL. 34982-5652
Phone(772)462-1553,FAX(772).462-1608
PLANNING.& DEVELOPMENT
BOARD OF 'SERVICES DEPARTMENT-
COUNTY v'L� _
COMMISSIONERS }_ `� Building'and Code, Regulation
o .
- _ _ _ Division
Electrical Affidavit
Date V I a� l a o
Parcel ID# 3,46 1 - -D 15.7 0.0 0.3. 0 n b dL
Address uvL �4\� R_. .Z`�"�U� �-
Permit
I have requested to install ailv additional electric service/meter at the above named property, By
signing this affidavit-1 fully-agree that the additional electfical:service/meter does not Allow for-the
following:
• Operation of a-business venture or entity within the accessory structure in violation of the_LDC
• Renting-or leasing any portion of the accessory structure in violation of the LDC
• Converting accessory-structure into additional occupied or:living space in violation of the LDC
I fully,understand:that if the conditions of this affidavit is,fo nd in violation, power may be shut
off to the building without notice:
Print Owner's Name' Sig tune of 0 er
STATE Or FLORIDA,COUNTY OF 5 1. .GUL-1 J�_
SWORN TO(OR AFFIRMED)AND SUBSCRIBED BEFORE ME OF PHYSICAL PRESENCE OR
ONLINE-NOTORILATION7HIS jt~{1 DAY; F 20,40 ,
NAME OF PERSON MAKING STATEMENT
PERSONALLYKNOWN_ OR PRODUCED IDENTIFICATION
TYPE or IDENTIFICATION PRODUCED
1w&e .. . A,
IGNATU 'OFNOTARY PUBLIC TYPE OR PRINTNOTARY
4-61A$I?57 COMMISSION NUMBER
KATFMP E CARUANA
• My COMMISSION#GG128195
'f C, iry EXPIRES July 25,2021
Websile:www.stlucieco:aov
2300 Virginia-Avenue Fort Pierce.FL.. 34982-5652
Phone(772)462-1553 FAX(772)462-1578